Causes of Dyspareunia

List of causes of Dyspareunia

Following is a list of causes or underlying conditions (see also Misdiagnosis of underlying causes of Dyspareunia) that could possibly cause Dyspareunia includes:

• Poor vaginal lubrication
• Reduced libido
• Reduced estrogen
• Vaginal dryness
  • Inadequate foreplay
  • Menopause
  • Perimenopause
  • Lactation - causes vaginal dryness
  • Sjogren's syndrome
  • Scleroderma
  • See other causes of vaginal dryness
• Some other causes of intercourse pain in women include:
  • Post-childbirth
  • Episiotomy - if performed for childbirth
  • Vaginal infection
  • Cystitis
  • Urethritis
  • Vaginal infection
  • Vulva infection
  • Skin condition
  • Atrophic vaginitis
  • Vaginal abnormality
  • Vestigial vagina
  • Vaginal changes from childbirth
  • Narrow vaginal
  • Hymen
  • Psychological disorders
  • Anxiety
  • Vaginismus
  • Endometriosis
  • Hemorrhoids
  • Endometriosis
  • Pelvic infection
  • Pelvic inflammatory disease
  • Genital tract tumor
  • Vaginal tumors
  • Vaginal surgery
  • Pelvic disorders
  • Sexual organ disorders
• Some causes of deep penetration intercourse pain in women include:
  • Pelvic inflammatory disease
  • Pelvic tumor
  • Irritable bowel syndrome
  • Endometriosis
• See also causes of painful intercourse and vaginal dryness

More causes: see full list of causes for Dyspareunia

Causes of Dyspareunia (Diseases Database):

The follow list shows some of the possible medical causes of Dyspareunia that are listed by the Diseases Database:

• Functional disorders
• Prolactin secreting pituitary tumour
• Vaginismus
• Atrophic vulvovaginitis
• Episiotomy
• Bartholin gland cyst
• Menopause
• Trichomonas vaginalis
• Pelvic inflammatory disease
• Lichen sclerosus et atrophicus
• Endometriosis
• Herpes simplex
• Herpes virus 2
• Imperforate hymen
• Genital ulcers
• Sicca syndrome
• Anal fissure
• Kraurosis vulvae
• Vulvovaginitis
• Candida albicans

Causes of Dyspareunia: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Dyspareunia.

Dyspareunia: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Definitions
  –Sexual pain disorder: Persistent or recurrent genital pain of nonorganic cause associated with sexual stimulation, thus causing personal stress; subcategories include dyspareunia and vaginismus
  –Superficial dyspareunia: Pain or dysfunction felt upon initial penetration
  –Deep dyspareunia: Pain or dysfunction felt deep within the pelvis during intercourse
  –Vaginismus: Painful involuntary spasm of the vagina, preventing intercourse
  –Vulvar vestibulitis: A chronic and persistent clinical syndrome characterized by severe pain with vestibular touch or attempted vaginal entry, tenderness in response to pressure within the vulvar vestibule, and physical findings confined to various degrees of vestibular erythema
  –Vulvodynia: Chronic vulvar discomfort (e.g. burning, stinging, irritation, rawness)

• Neurologic etiologies: Nerve damage or infection, dysesthetic (essential) vulvodynia
• Gynecologic etiologies: Gynecologic tumors (e.g., vulvar, cervical, uterine, ovarian, or rectal cancer; fibroids), Bartholin's gland inflammation
• GI: Constipation, irritable bowel syndrome, colitis, diverticulitis, GI tumors (in pelvis)
• Urinary: Interstitial cystitis, urethritis, urethral diverticulum
• Infectious: Endometritis, vaginitis, PID, salpingitis, vulvovaginitis, herpes genitalis, post-herpetic neuralgia, Bartholin's abscess
• Dermatologic etiologies: Vaginal atrophy, lichen sclerosis, Behçet syndrome, contact dermatitis
• Musculoskeletal: Pelvic floor myopathy, fibromyalgia, levator ani myalgia, dysfunctional vaginismus
• Endocrine: Estrogen deficiency, endometriosis
• Psychiatric: Female sexual dysfunction(s)
• Iatrogenic: Surgical (e.g., pelvic adhesions, episiotomy, strictures), pharmacologic (drying soaps or agents, topical medications, OCPs)
• Trauma: Vaginal lacerations or ecchymoses
• Primary pain disorder
• Severely retroverted uterus
• Imperforate hymen

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Dyspareunia: Causes
(Professional Guide to Diseases (Eighth Edition))

Physical causes of dyspareunia include an intact hymen; deformities or lesions of the introitus or vagina; marked retroversion of the uterus; genital, rectal, or pelvic scar tissue; acute or chronic infections of the genitourinary tract; and disorders of the surrounding viscera (including residual effects of pelvic inflammatory disease or disease of the adnexal and broad ligaments).

Among the many other possible physical causes are:

❑ endometriosis

❑ benign and malignant growths and tumors

❑ insufficient lubrication

❑ radiation to the area

❑ allergic reactions to diaphragms, condoms, or other contraceptives.

Psychological causes include fear of pain or of injury during intercourse, recollection of a previous painful experience, guilty feelings about sex, fear of pregnancy or of injury to the fetus during pregnancy, anxiety caused by a new sexual partner or technique, and mental or physical fatigue. Men and women can suffer pain in the pelvic area during or soon after sexual intercourse.

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Dyspareunia: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Allergies

Allergic reactions to diaphragms or condoms may result in dyspareunia.

Atrophic vaginitis

In postmenopausal and breast-feeding women, decreased estrogen secretion may lead to inadequate vaginal lubrication and dyspareunia, which intensifies as intercourse continues. Accompanying signs and symptoms include pruritus, burning, bleeding, and vaginal tenderness. Patients may complain of a watery discharge at the same time that they’re feeling “dry.”

Bartholinitis

This inflammatory disorder may produce throbbing pain accompanied by vulvar tenderness during intercourse. The patient may also complain of pain with walking or sitting. Chronic inflammation causes a purulent discharge from the infected cyst.

Cervicitis

This inflammatory disorder causes pain with deep penetration. It may also cause dull lower abdominal pain, a purulent vaginal discharge, backache, and metrorrhagia.

Condylomata acuminata

These papular, mosaic, warty growths occur on the vulva, vaginal and cervical walls, and perianal area. They may bleed, itch, cause burning or paresthesia in the vaginal introitus, and become tender during and after intercourse. A profuse, odorless vaginal discharge may also occur.

Cystitis

Dyspareunia may occur if the patient has inflammation or infection of the bladder. Associated findings include dysuria; urinary urgency, frequency, or incontinence; pyuria; and, after coitus, hematuria.

Endometriosis

This disorder causes intense pain during deep coital penetration. In addition, aching pain may occur during gentle thrusting or during a pelvic examination. The pain is usually in the lower abdomen or behind the uterus and may be worse on one side. It may be relieved by changing coital positions. Other signs and symptoms include dysmenorrhea, irregular menses, infertility, painful urination or defecation, and rectal bleeding and hematuria during menses. Typically, a tender, fixed adnexal mass is palpable on bimanual examination.

Herpes genitalis

During intercourse, friction against lesions on the labia, vulva, vagina, or perianal skin causes pain and itching. The lesions are fluid-filled and usually painless at first, but may rupture and form shallow, painful ulcers with erythema and edema. Related findings include leukorrhea, fever, malaise, headache, inguinal lymphadenopathy, myalgia, and dysuria.

Occlusive or rigid hymen

Dyspareunia may prevent penetration in this condition.

Ovarian cyst or tumor

In this disorder, lower abdominal pain accompanies deep penetration during intercourse. Other signs and symptoms include chronic lower back pain; a tender, palpable abdominal mass; constipation; urinary frequency; menstrual irregularities; and hirsutism.

Pelvic inflammatory disease

Deep penetration causes severe pain that’s unrelieved by changing coital positions. Uterine tenderness may also occur with gentle thrusting or during a pelvic examination. This disorder also causes fever; malaise; a foul-smelling, purulent vaginal discharge; menorrhagia; dysmenorrhea; a soft, enlarged uterus; severe abdominal pain; nausea and vomiting; cervical motion tenderness; and diarrhea.

Uterine prolapse

Sharp or aching pain occurs when the penis strikes the descended cervix of a patient with uterine prolapse. Other effects are dysmenorrhea, pelvic pressure, leukorrhea, urine retention and urinary incontinence, and chronic lower back pain.

Vaginitis

This infection produces dyspareunia along with vulvar pain, burning, and itching during and for several hours after coitus. These symptoms may be aggravated by sexual arousal aside from intercourse. Vaginal discharge is typical; the type varies with the causative organism. Candida albicans produces a curdlike, odorless to musty-smelling discharge; Trichomonas vaginalis produces a yellow-green, frothy, fish-smelling discharge; bacterial vaginosis and Neisseria gonorrhoeae produce a profuse whitish yellow, foul-smelling discharge. Pruritus and dysuria may also occur.

Other causes

Contraceptive and hygienic products

Some spermicidal jellies, douches, and vaginal creams and deodorants cause irritation and edema, resulting in dyspareunia.

Diaphragms and intrauterine devices

An ill-fitting diaphragm may produce cramps with intercourse. An incorrectly placed intrauterine device may cause dyspareunia during orgasm.

Drugs

Antihistamines, decongestants, and nonsteroidal anti-inflammatory drugs decrease lubrication, resulting in dyspareunia.

Episiotomy

If the episiotomy scar constricts the vaginal introitus or narrows the vaginal barrel, the patient may experience perineal pain with coitus.

Pelvic irradiation

Radiation therapy for pelvic cancer may cause pelvic and vaginal scarring, resulting in dyspareunia.

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Dyspareunia as a symptom:

Conditions listing Dyspareunia as a symptom may also be potential underlying causes of Dyspareunia. Our database lists the following as having Dyspareunia as a symptom of that condition:

• Allen-Masters syndrome
• Autoimmune Endometriosis
• Autoimmune Interstitial Cystitis
• Dyspareunia
• Endometrial conditions
• Female infertility
• Female sexual conditions
• Genital system cancer
• Gynaecological conditions
• Renal nutcracker syndrome
• Trichomoniasis
• Uterine sarcoma
• Vagina cancer
• Virilising ovarian tumour
• Vulvar vestibulitis syndrome
• Yolk sack tumour

Related information on causes of Dyspareunia:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Dyspareunia may be found in:

• Hidden causes of Dyspareunia