Pain at the vaginal opening during sex

Pain at entry often feels like burning, stinging, cutting, or tightness at the opening rather than deep pelvic pain. Friction, inadequate lubrication, hormonal dryness, irritation from products, or a skin condition can contribute. Pelvic-floor muscles may tighten in response to anticipated pain, creating a cycle of discomfort. Infection can cause soreness, discharge, itching, or pain with urination. Deeper pain or cycle-related symptoms may point to conditions such as endometriosis or pelvic inflammatory disease. An examination is needed to tell these causes apart.

Stop or change any activity that hurts; pain is a reason to pause, not push through. Allow more time for arousal, use a plain water- or silicone-based lubricant, and avoid scented washes or douching. Notice whether symptoms follow a new product, medication, childbirth, menopause, or infection concern. Arrange a clinician visit if pain recurs, causes avoidance, or comes with discharge, sores, bleeding, or urinary symptoms. Treatment depends on the finding and may involve pelvic-floor care, treatment for infection, or support for vaginal dryness.

Seek prompt care for severe pain, fever, vomiting, faintness, heavy bleeding, new sores, or rapidly worsening swelling. Arrange sexual-health assessment for unusual discharge, a strong odour, pelvic pain, or a partner with a possible infection. Persistent entry pain also deserves review because vulvodynia, lichen sclerosus, and other conditions can need specific treatment.

Is the pain coming from the skin, vaginal tissue, pelvic floor, or deeper pelvis? Should I have infection testing or an examination? Which lubricant or treatment is suitable for my symptoms?