What should you know about having pain during sex?

Pain at the entrance may relate to dryness, irritation, skin conditions such as lichen sclerosus, involuntary pelvic-floor tightening or vulvodynia. Deeper pain can occur with endometriosis, ovarian endometrioma, pelvic inflammatory disease or other pelvic conditions. Genitourinary syndrome of menopause may cause dryness, burning and tissue sensitivity. Emotional stress can amplify muscle tension, but the pain remains physical and valid.

Notice whether pain is at entry or deep inside, whether it follows a particular position, and whether there is bleeding, discharge, itching, urinary discomfort or cycle-related pain. Do not continue an activity that hurts.

Pause or change sexual activity, allow more arousal time, and use a suitable lubricant if dryness is contributing. Avoid fragranced products and harsh washing around the vulva. A clinician can assess tissues, infection, pelvic muscles and the wider history, then discuss targeted treatment; surgery is not automatically needed.

Arrange an appointment for ongoing or recurring pain, pain with bleeding, unusual discharge, itching, sores, urinary symptoms or a change after menopause. Seek urgent help for severe pelvic pain, fever, fainting, vomiting, or possible pregnancy with pain or bleeding.

Ask what examination or swabs may clarify the cause, whether pelvic-floor therapy or local treatment could help, and how to manage intimacy while symptoms settle. If endometriosis is suspected, ask when specialist assessment or laparoscopic excision should be discussed.