Differential Diagnosis for Painful Intercourse
Single Most Likely Diagnosis
- Vulvodynia: This condition is characterized by chronic pain in the vulva, which can be exacerbated by intercourse. It's a common cause of painful intercourse and should be considered first due to its prevalence.
Other Likely Diagnoses
- Vaginismus: A condition where the vaginal muscles involuntarily contract, making intercourse painful. It's often associated with anxiety or fear of intercourse.
- Endometriosis: A condition where tissue similar to the lining inside the uterus grows outside of it, leading to pain during intercourse, especially if the endometrial implants are located behind the vagina or on the uterosacral ligaments.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause pain during intercourse due to inflammation and scarring.
- Yeast Infections or Bacterial Vaginosis: These infections can cause discomfort and pain during intercourse due to inflammation and irritation of the vaginal tissues.
Do Not Miss Diagnoses
- Ovarian Cysts: Large or ruptured ovarian cysts can cause severe pain during intercourse, and while not the most common cause, missing a ruptured cyst could be life-threatening.
- Ectopic Pregnancy: Although rare, an ectopic pregnancy can cause pain during intercourse and is a medical emergency if ruptured.
- Cervical Cancer: Advanced cervical cancer can cause pain during intercourse, and missing this diagnosis could significantly impact treatment outcomes and survival.
Rare Diagnoses
- Lichen Sclerosus: A rare skin condition that can cause thinning and patchy skin in the genital area, leading to pain during intercourse.
- Vaginal Atrophy: Thinning and drying of the vaginal walls, often due to decreased estrogen levels, which can cause pain during intercourse.
- Pudendal Neuralgia: A condition characterized by pain in the distribution of the pudendal nerve, which can be exacerbated by intercourse.
- Interstitial Cystitis: A condition causing bladder pressure, bladder pain, and sometimes pelvic pain, which can be worsened by intercourse.