Which condition is most commonly associated with dyspareunia in older women?

Atrophic vaginitis is the condition most commonly associated with dyspareunia, particularly in older women. This condition occurs due to a decrease in estrogen levels, often seen during menopause, leading to thinning and inflammation of the vaginal tissues. The result is discomfort or pain during intercourse, which is a primary symptom of dyspareunia.

In older women, the decreased estrogen can cause the vaginal walls to become less elastic and dry, making sexual intercourse painful and leading to the overarching issue of dyspareunia. Management typically involves hormone replacement therapy or topical estrogen treatments to alleviate these symptoms and restore vaginal health.

Other conditions like ectopic pregnancy, psoas syndrome, and osteoporosis may also cause pain or discomfort, but they are not specifically linked to sexual pain in the context of aging women. Ectopic pregnancy is a medical emergency related to pregnancy and is not common in older women who may be post-menopausal, psoas syndrome relates more to musculoskeletal issues, and while osteoporosis can lead to fractures, it does not directly correlate with dyspareunia.