What should you know about IUD pain during sex?

Deep pain can reflect pressure on the cervix, pelvic floor tension, endometriosis, an ovarian endometrioma, or pelvic inflammatory disease. Pain at the entrance may relate to dryness, irritation, vulvodynia, lichen sclerosus, or genitourinary changes after menopause. The IUD strings may occasionally be felt, but a partner feeling the strings is not the same as the device causing deep pain. Pain during sex is a common presentation of several pelvic and vulval conditions, so the symptom alone does not identify one diagnosis.

Tell the clinician whether pain is at the entrance or deep inside, whether it occurs with every position, and whether there is bleeding, discharge, fever, or urinary discomfort. A pelvic examination and, when indicated, pregnancy or infection testing can clarify the cause.

Pause penetration, choose activities that do not hurt, and use a water-based lubricant if dryness may contribute. Do not attempt to trim or remove the IUD strings yourself. Book a review if pain persists, begins after insertion, returns repeatedly, or is accompanied by bleeding or discharge. A clinician can check the strings and device position and discuss treatment for an underlying condition.

Get urgent care for severe or rapidly worsening pelvic pain, fainting, fever, vomiting, heavy bleeding, or a positive pregnancy test with pain. Seek prompt review for foul-smelling discharge, pain with fever, or bleeding after sex that keeps recurring. These features may need testing for infection, pregnancy-related problems, or another pelvic disorder.

Ask whether the pain is superficial or deep, whether the IUD position needs checking, and whether an examination or infection tests are appropriate. Ask about lubricant, pelvic floor care, and treatment options if endometriosis or another condition is suspected.