Differential Diagnosis for Vaginal Skin Splitting on Intercourse in a Young Woman
- Single most likely diagnosis
- Vaginal dryness or atrophy: This condition is often due to hormonal changes, lack of estrogen, or inadequate lubrication during intercourse, leading to vaginal skin splitting.
- Other Likely diagnoses
- Vulvar vestibulitis: Characterized by chronic pain and inflammation of the vulvar vestibule, which can cause discomfort and skin splitting during intercourse.
- Vaginismus: A condition where the vaginal muscles involuntarily contract, making intercourse painful and potentially leading to skin splitting.
- Lichen sclerosus: A skin condition that can cause thinning and splitting of the vaginal skin, especially if left untreated.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Infectious diseases (e.g., herpes simplex, syphilis): Certain infections can cause painful ulcers or lesions that may lead to skin splitting during intercourse.
- Malignancy (e.g., vaginal cancer): Although rare, vaginal cancer can cause skin changes, including splitting, and must be ruled out.
- Rare diagnoses
- Ehlers-Danlos syndrome: A genetic disorder that affects collagen production, potentially leading to fragile skin and increased risk of skin splitting.
- Sjögren's syndrome: An autoimmune disorder that can cause vaginal dryness and skin splitting due to decreased moisture production.