Genital mutilation may be the cause.
Pain during intercourse is called dyspareunia. The main causes are;
1) Inadequate lubrication
2) Deficiency of estrogen hormones; predisposes for inadequate lubrication
3) Urinary tract infection
4) Vulvovaginitis; various infections
6) Retroverted or prolapsed uterus
There are a host of other reasons too; infections, vaginal spasm, and inadequate lubrication are one of the commonest out of them One of the main and important causes in women of young age is vulvar vestibulodynia/vulvodynia. Vulvar vestibulodynia can be treated, reduced or prevented with topical xylocaine application. It is available over the counter. You should discuss this possibility with your gynecologist and than discuss various possibilities of the treatment as following (some combination can be determined for the first step of the treatment and if it is less effective, next treatment can be considered);
a) initial treatment of vulvodynia is amitriptyline, nortriptyline. Gabapentin or pregabalin may be considered as adjunctive therapy in addition to these medications.
b) Local provoked vulvodynia ( as in your case; called as vestibulodynia) refractory to other treatments, surgical excision of the vestibule may be considered.
c) In vulvodynia and sex-related pain, pelvic floor muscle dysfunction should be evaluated and treated. Techniques to desensitize the pelvic floor muscles are very helpful. The treatment is following;
1) electro galvanic stimulation,
2) biofeedback training,
3) digital massage of the levator ani muscles
4) sacral nerve stimulation
5) physical therapy for the pelvic floor muscles.
d) Acupuncture may be considered, which is helpful in a significant number of women.
e) For provoked vulvodynia (sexual pain), intralesional injections may be considered.
Please read these excellent authentic resources on painful intercourse (Dyspareunia);
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