Most common cause of dyspareunia

Pain at the entrance may reflect dryness, irritation, involuntary pelvic-floor tightening, vulvodynia or lichen sclerosus. Deeper pain can be associated with endometriosis, an ovarian endometrioma or pelvic inflammatory disease. Hormonal changes around menopause may cause genitourinary syndrome of menopause, with dryness and fragile tissues. The location, timing, burning or aching quality, and whether pain continues afterward help guide assessment.

[Pain During Sex](/symptoms/pain-during-sex/) describes the symptom. A clinician may examine the vulva and vagina, check for infection, discuss medicines and contraception, and assess pelvic muscles or deeper pelvic tenderness.

Pause or modify activity when pain begins, allow more arousal time, and consider a suitable lubricant or vaginal moisturiser. Avoid scented washes and products that sting. Book an appointment when pain persists, returns, or affects intimacy. Treatment is cause-specific: hormonal options may help tissue changes, pelvic-floor therapy may address muscle guarding, and infection or inflammatory disease needs its own treatment. Endometriosis care may include medication or, in selected cases, [Laparoscopic Excision of Endometriosis](/treatments/gynaecological-surgery/laparoscopic-excision-of-endometriosis/).

Seek prompt care for pain with fever, unusual discharge, bleeding after sex, sores, pelvic tenderness or possible pregnancy. Sudden severe pelvic pain, fainting or heavy bleeding needs urgent evaluation. Pain that follows sexual trauma, or fear that makes examination difficult, also warrants sensitive support and a clinician-led plan.

Is the pain superficial or deep, and what causes fit that pattern? Could dryness, pelvic-floor tension, infection, endometriosis or a vulval skin condition be contributing? Which lubricant or treatment is suitable for me? What symptoms should prompt urgent review?