Men and women with this sexual dysfunction disorder experience otherwise unexplained genital pain before, during or after intercourse.

Diagnostic criteria for 302.76 Dyspareunia 
( cautionary statement )

Recurrent or persistent genital pain, associated with sexual intercourse in either a male or a female). In women, it is generally defined as genital pain occurring with penetration or during or after intercourse but not exclusively vaginismus (a common type of insertional dyspareunia caused by intense involuntary contraction of the perineal muscles surrounding the outer one third of the vagina). True dyspareunia is recurrent and associated with a disruption of normal functioning. The disturbance causes marked distress or interpersonal difficulty. The disturbance is not caused exclusively by vaginismus or lack of lubrication. Diagnostic criteria is as follows:

• The patient often experiences genital pain with sexual intercourse.
• It is due neither to Vaginismus nor inadequate lubrication.
• Except for another Sexual Dysfunction.
• It is not directly caused by substance use (medication or drug of abuse) or by a general medical condition.
• It causes marked distress or interpersonal problems.

Associated Features:

Abuse (past or present)
Arousal disorders
Insufficient foreplay
Medications
Anxiety
Depression
Somatic or Sexual Dysfunction

Differential Diagnosis:

Some disorders have similar or even the same symptoms. The clinician, therefore, in his/her diagnostic attempt has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.

Vaginismus

Cause:

Dyspareunia is a symptom of multiple and varied disease states and may have multiple causes with components of both organic and psychiatric dysfunction.

Women with dyspareunia were found to have more physical pathology and greater psychological symptoms. They reported more negative attitudes toward sexuality, higher levels of sexual impairment, and lower levels of marital adjustment, but they did not report more physical or sexual abuse, either past or present. Subjects with the greatest psychological symptoms and marital maladjustment had no discernible physical findings on examination, and their levels of sexual function were similar to those of matched controls.

Treatment:

Depending on your history, the results of a medical exam and other diagnostic tests treatment for dspareunia may include some of the following options:

Counseling and Psychotherapy:

Relaxation exercises may help a woman regain control over vaginal muscles, reducing pain and making sexual intercourse more pleasurable.

Medical & Other:

Position Change:  In the case of a tipped uterus, a change in position may allow the uterus to move and result in more comfortable intercourse.  

Medications:  In the case of an infection, treatment with medication often solves the problem.

Lubrication: Use of a cream or jelly can help make sexual intercourse more comfortable in cases when there is not enough natural lubrication.