During sex I feel pain: what should I know?

Pain at the entrance may relate to dryness, skin irritation, involuntary pelvic-floor tightening, or a condition such as Vulvodynia or Lichen Sclerosus. Deeper pain may occur with Endometriosis, an Ovarian Endometrioma, or Pelvic Inflammatory Disease. The timing matters: note whether pain starts with penetration, develops with deeper movement, continues afterward, or appears with bleeding, discharge, itching, urinary symptoms, or pelvic pain. Pain is a symptom, not a diagnosis, and a painful episode does not by itself identify its cause.

Hormonal changes around menopause can thin and dry vaginal tissue; Genitourinary Syndrome of Menopause is one possible explanation. A clinician can discuss examination and testing based on your symptoms.

Stop or change activity when pain begins rather than pushing through it. Allow more time for arousal, consider a suitable lubricant, and choose positions where you control depth and pace. Avoid fragranced washes and products that sting. Record the location, trigger, cycle timing, and associated symptoms so your clinician can see a pattern. Treatment depends on the cause and may include care for infection or skin disease, pelvic-floor therapy, hormonal treatment, or other targeted options. For selected endometriosis, Laparoscopic Excision of Endometriosis may be discussed by a specialist.

Arrange a gynaecology or primary-care appointment if pain keeps returning, affects intimacy, or comes with unusual discharge, itching, bleeding after sex, urinary symptoms, or pain outside sex. Seek urgent care for sudden severe pelvic pain, heavy bleeding, fever with pelvic pain, fainting, or possible pregnancy with pain or bleeding.

Could the pain be coming from the vaginal opening, pelvic muscles, cervix, or deeper pelvic organs? What examination or tests fit my symptoms? Which treatments are safe with my contraception, pregnancy plans, or menopause status?