Hi. The probable causes of Dyspareunia that is painful sexual intercourse are: Pelvic Inflammatory disease (PID). Appendivitis TO (Tubo-oavarian) mass Hydrosalpinx is severe inflammatory swelling of the Fallopian tube Twisted ovarian cyst all these things by virtue of inflammation cause painful intercourse. I would advise ::: First of all a manual per-vaginal examination by a Gynecologist after careful complete history is told. Secondly - Ultrasonography CT scan may be necessary if clinical impression suggests something is missing or to confirm the findings of the USG. The treatment will depend upon the diagnosis.