Sandbox:Dyspareunia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Vishnu Vardhan Serla M.B.B.S. [2] Luke Rusowicz-Orazem, B.S.

Overview

Common causes of dyspareunia include localized infectious and congenital disorders of the vulva, vagina, and perianal regions. Additional causes include systemic conditions and diseases.

Causes

Common Causes

• Anal fissure
• Anxiety
• Atrophic vulvovaginitis
• Bartholin gland cyst
• Candida albicans
• Candidiasis
• Chlamydia
• Depression
• Endometriosis
• Episiotomy
• Functional disorders
• Genital ulcers
• Herpes simplex virus
• Herpes virus 2
• Imperforate hymen
• Kraurosis vulvae
• Lichen sclerosus
• Menopause
• Pelvic inflammatory disease
• Sicca syndrome
• Trichomonas vaginalis
• Vaginismus
• Vulvovaginitis

Causes by Organ System

Cardiovascular	Hemorrhoids, Renal nutcracker syndrome , Thrombosed piles
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	Allergic contact dermatitis, Healed perineal lacerations, Irritant contact dermatitis, Kraurosis vulvae, Lichen planus, Lichen sclerosus, Obstetric perineal injury
Drug Side Effect	No underlying causes
Ear Nose Throat	Sjögren's syndrome
Endocrine	Menopause, Perimenopause, Prolactin secreting pituitary tumour, Prolactinoma, Reduced estrogen, Reduced libido
Environmental	No underlying causes
Gastroenterologic	Inflammatory bowel disease , Irritable bowel syndrome
Genetic	Congenital absence of lower part of vagina, Müllerian anomalies
Hematologic	No underlying causes
Iatrogenic	Episiotomy, Gynecologic surgery, Obstetric surgery, Vaginal surgery
Infectious Disease	Atrophic vaginitis, Atrophic vulvitis, Atrophic vulvovaginitis, Autoimmune interstitial cystitis , Bartholin gland cyst, Bartholinitis, Candida albicans, Candidiasis, Chlamydia, Cystitis, Herpes simplex virus, Herpes virus 2, Pelvic infection, Trichomonas vaginalis, Trichomonas, Trichomoniasis , Urethritis, Urinary tract infection, Vaginitis, Vulva infection, Vulvovaginitis
Musculoskeletal/Orthopedic	Parkinson’s disease, Vaginismus, Vulval dystrophy
Neurologic	Parkinson’s disease, Peripheral neuropathies
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	Atrophic vaginitis, Atrophic vulvitis, Atrophic vulvovaginitis, Autoimmune endometriosis , Autoimmune interstitial cystitis , Bartholin gland cyst, Bartholinitis, Chronic pain syndromes, Congenital absence of lower part of vagina, Endometrial conditions, Endometriosis, Episiotomy, Estrogen deficiency, Estrogen-based contraceptives, Female genital mutilation, Genital system cancer , Genital tract tumor, Genital ulcers, Gonorrhea, Gynaecological conditions , Gynecologic surgery, Healed perineal lacerations, Hemorrhoids, Imperforate hymen, Inflamed hymeneal orifice, Lactation, Myofascial pelvic pain syndrome, Narrow vagina, Obstetric perineal injury, Obstetric surgery, Ovarian tumour, Pelvic adhesions, Pelvic disorders, Pelvic infection, Pelvic inflammatory disease, Pelvic malignancy, Pelvic organ prolapse, Pelvic tumor, Perimenopause, Poor vaginal lubrication, Post-childbirth, Prolapsed tender ovaries with retroverted uterus, Provoked vulvar pain, Remnants of the hymen, Salpingo-oophoritis, Unruptured hymen, Vagina cancer, Vaginal abnormality, Vaginal dryness, Vaginal surgery, Vaginismus, Virilising ovarian tumour , Vulva infection, Vulval dystrophy, Vulval neoplasia, Vulvar vestibulitis syndrome , Vulvitis, Vulvodynia, Vulvovaginitis
Oncologic	Genital system cancer , Genital tract tumor, Ovarian tumour, Pelvic malignancy, Pelvic organ prolapse, Pelvic tumor, Prolactin secreting pituitary tumour, Prolactinoma, Uterine sarcoma , Uterine tumour, Vagina cancer, Virilising ovarian tumour , Vulval neoplasia, Yolk sack tumour
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	Anxiety, Depression, Psychological disorders, Reduced libido, Relationship dysfunction
Pulmonary	No underlying causes
Renal/Electrolyte	Interstitial cystitis, Renal nutcracker syndrome
Rheumatology/Immunology/Allergy	Arthritis of the hips, Fibromyalgia, Kraurosis vulvae, Lichen planus, Menopause, Scleroderma, Sicca syndrome, Sjögren's syndrome
Sexual	Chlamydia, Estrogen-based contraceptives, Female genital mutilation, Genital ulcers, Gonorrhea, Herpes simplex virus, Herpes virus 2, Trichomonas vaginalis, Trichomonas, Trichomoniasis
Trauma	Allen-masters syndrome , Anal fissure, Cystitis, Trauma
Urologic	Interstitial cystitis, Peyronie's disease, Urethral caruncle, Urethritis, Urinary tract infection, Uterine sarcoma , Uterine tumour
Miscellaneous	Relationship dysfunction

Causes in Alphabetical Order

• Allen-masters syndrome
• Allergic contact dermatitis
• Anal fissure
• Anxiety
• Arthritis of the hips
• Atrophic vaginitis
• Atrophic vulvitis
• Atrophic vulvovaginitis
• Autoimmune endometriosis 
• Autoimmune interstitial cystitis 
• Bartholin gland cyst
• Bartholinitis
• Candida albicans
• Candidiasis
• Chlamydia
• Chronic pain syndromes
• Congenital absence of lower part of vagina
• Cystitis
• Depression
• Endometrial conditions
• Endometriosis
• Episiotomy
• Estrogen deficiency
• Estrogen-based contraceptives
• Female genital mutilation
• Fibromyalgia
• Functional disorders
• Genital system cancer
• Genital tract tumor
• Genital ulcers
• Gonorrhea
• Gynaecological conditions
• Gynecologic surgery
• Healed perineal lacerations
• Hemorrhoids
• Herpes simplex virus
• Herpes virus 2
• Imperforate hymen
• Inflamed hymeneal orifice
• Inflammatory bowel disease 
• Interstitial cystitis
• Irritable bowel syndrome
• Irritant contact dermatitis
• Kraurosis vulvae
• Lactation
• Leucoplakia
• Lichen planus
• Lichen sclerosus
• Menopause
• Müllerian anomalies
• Multiple sclerosis
• Myofascial pelvic pain syndrome
• Narrow vagina
• Obstetric perineal injury
• Obstetric surgery
• Ovarian tumour
• Parkinson’s disease
• Pelvic adhesions
• Pelvic disorders
• Pelvic infection
• Pelvic inflammatory disease
• Pelvic malignancy
• Pelvic organ prolapse
• Pelvic tumor
• Perimenopause
• Peripheral neuropathies
• Peyronie's disease
• Poor vaginal lubrication
• Post-childbirth
• Postmenopause
• Prolactin secreting pituitary tumour
• Prolactinoma
• Prolapsed tender ovaries with retroverted uterus
• Provoked vulvar pain
• Psychological disorders
• Reduced estrogen
• Reduced libido
• Relationship dysfunction
• Remnants of the hymen
• Renal nutcracker syndrome 
• Salpingo-oophoritis
• Scleroderma
• Sicca syndrome
• Sjögren's syndrome 
• Thrombosed piles
• Trauma
• Trichomonas
• Trichomonas vaginalis
• Trichomoniasis 
• Unruptured hymen
• Urethral caruncle
• Urethritis
• Urinary tract infection
• Uterine sarcoma 
• Uterine tumour
• Vagina cancer
• Vaginal abnormality
• Vaginal changes from childbirth
• Vaginal dryness
• Vaginal surgery
• Vaginismus
• Vaginitis
• Vestigial vagina
• Virilising ovarian tumour 
• Vulva infection
• Vulval dystrophy
• Vulval neoplasia
• Vulvar vestibulitis syndrome 
• Vulvitis
• Vulvodynia
• Vulvovaginitis
• Yolk sack tumour