Pain during sex: what to know

Pain at the entrance can be linked with dryness, irritation, involuntary pelvic-floor tightening, vulvodynia or skin conditions such as lichen sclerosus. Deeper pain can occur with endometriosis, an ovarian endometrioma, pelvic inflammatory disease or other pelvic conditions. Genitourinary syndrome of menopause may cause dryness and tissue sensitivity after hormonal changes.

The timing and location help guide assessment: pain with first touch differs from pain with deep penetration, and burning differs from pressure or cramping. A clinician may ask about discharge, bleeding, urinary symptoms, periods, childbirth, contraception and emotional safety.

Pause when pain starts rather than pushing through it. A longer period of arousal, lubricant and positions that allow you to control depth may reduce friction or pressure. Avoid scented washes and products that sting. Arrange an assessment if symptoms continue; treatment depends on the cause and may include pelvic-floor therapy, treatment for infection, hormonal care or specialist management. Surgery such as laparoscopic excision is considered only for selected causes such as endometriosis.

Seek prompt medical care for severe or sudden pelvic pain, fever, vomiting, faintness, heavy bleeding, new sores, or unusual discharge with a strong smell. Pain after a possible sexual assault also warrants urgent support and compassionate care.

Ask where the pain seems to arise, whether an examination or infection test is needed, what self-care is suitable, and which treatments match the suspected cause.