Why can intercourse cause lower abdominal pain?

Pain may be felt at the entrance, deeper in the pelvis, or afterward. Deep pain can be associated with conditions such as endometriosis, adenomyosis, ovarian cysts, pelvic inflammatory disease, or uterine fibroids. Tight pelvic floor muscles, vaginal dryness, irritation, or a position that increases pressure can also contribute. The location, timing, cycle pattern, discharge, bleeding, and urinary or bowel symptoms help a clinician narrow the possibilities. Pain during intercourse is a symptom, not a diagnosis.

Stop or change activity when pain begins; consent and comfort come first. Consider a slower pace, more lubrication, and positions that limit deep pressure if these feel comfortable. Record whether pain occurs with penetration, orgasm, or afterward, along with cycle timing and other symptoms. Book a gynaecology or primary-care appointment if pain recurs, affects intimacy, or comes with discharge, bleeding, fever, or urinary symptoms. Treatment depends on the cause and may include pelvic-floor care, infection treatment, or other medical options.

Seek urgent help for severe or rapidly worsening pain, fainting, shoulder-tip pain, heavy bleeding, fever with pelvic pain, repeated vomiting, or a positive pregnancy test with pain or bleeding. These symptoms can occur with urgent conditions such as ectopic pregnancy or pelvic infection. Do not wait for intercourse-related pain to settle if you feel very unwell.

Where does the pain suggest it is coming from? Should I have pregnancy or infection testing, an examination, or imaging? Could pelvic-floor therapy help? What should I do if intercourse remains painful while treatment is being arranged?