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Description:Multimodal treatment regimens need to be deployed, and a multidisci-plinary approach is usually necessary. In order to elucidate the features of this separate syndrome, the concept of vaginismus will be briefly reviewed, to which the separate syndrome can be compared. There are three main types of painful intercourse. It is not uncommon for such couples to present for help only when they feel ready to have a child and are now faced with a major hurdle. And, dermatological conditions such as squamous hyperplasia or lichen sclerosus may cause damage to the vulvar skin, making it tender to the touch. A drop in estrogen levels after menopause or childbirth or during breast-feeding also can be a cause. In patients who are unable to co-operate with the gynecologist, the central problem is to make the diagnosis.