What should you know about left abdominal pain during sex?

Pain on the left may occur with deep penetration, certain positions, muscle tightening, or irritation at the vaginal opening. Endometriosis and an ovarian endometrioma can present with deep pelvic pain during sex; pelvic inflammatory disease can also cause pelvic pain, often with unusual discharge or fever. Genitourinary syndrome of menopause may cause dryness and burning, while vulvodynia or lichen sclerosus can make contact at the vulva painful. These conditions can overlap, and left-sided pain alone does not identify one cause.

Note whether the pain starts at entry or with deeper movement, whether it follows the menstrual cycle, and whether bowel, bladder, bleeding, discharge, or fever symptoms occur.

Stop or change activity when pain begins; do not push through it. Record the location, timing, depth, cycle relationship, and accompanying symptoms. A clinician may examine the vulva and pelvis and may arrange testing or imaging based on the findings. Lubrication, slower movement, and positions that limit depth may reduce friction-related discomfort, but persistent or recurring pain deserves assessment. Treatment depends on the cause and may include pelvic-floor care or treatment for an identified condition.

Arrange prompt medical assessment for new or persistent pain, pain with fever, unusual discharge, bleeding after sex, vomiting, or urinary symptoms. Seek urgent help for sudden severe one-sided pain, faintness, shoulder-tip pain, or heavy bleeding, particularly if pregnancy is possible.

Ask whether the pain pattern suggests a pelvic, vulval, vaginal, or muscle-related source; whether an examination or scan is appropriate; and which symptoms should trigger urgent care. Mention cycle changes, discharge, bleeding, bowel symptoms, and any pregnancy possibility.