Muscle pain during sex: what to know

Pain at the entrance can involve involuntary tightening, dryness, sensitive vulval skin, or vulvodynia. Deeper pain may be linked with endometriosis, an ovarian endometrioma, or pelvic inflammatory disease. Genitourinary Syndrome of Menopause can make vaginal tissues drier and more delicate. Lichen sclerosus may cause soreness or skin changes. A muscle can also stay guarded after childbirth, surgery, an injury, or a painful sexual experience.

The location, timing, and character of pain help distinguish surface soreness from deeper pelvic pain. Burning, pulling, cramping, or pain that continues afterwards are useful details to record.

Pause or change any activity that causes pain, use a lubricant if dryness may contribute, and allow your body to relax rather than pushing through tightening. Gentle breathing with a slow, comfortable release of the pelvic floor may help; avoid forceful stretching or repeated contraction exercises while symptoms are active.

Arrange a gynaecology or pelvic-floor assessment if the pain keeps returning. An examination can check skin, muscles, infection, and pelvic causes. Treatment may include pelvic-floor physiotherapy, care for dryness or inflammation, or management of an identified condition. Laparoscopic Excision of Endometriosis may be discussed only when endometriosis is confirmed and symptoms warrant it.

Seek prompt medical care for severe or rapidly worsening pelvic pain, fever, vomiting, fainting, unusual bleeding, new discharge with a strong odour, or pain during pregnancy. Seek urgent help after sex if pain is sudden and intense or accompanied by weakness or heavy bleeding.

Could the pain be coming from the pelvic floor or from a deeper pelvic condition? What examination or tests fit the pain's location? Would pelvic-floor physiotherapy be appropriate, and what should I avoid until the cause is clearer?