Pain during period sex: what to know

The uterus can contract during a period, and pelvic tissues may feel more tender. Penetration can then intensify cramps or create deeper discomfort. Endometriosis and an ovarian endometrioma can cause pain that is linked with menstruation, while pelvic inflammatory disease may cause pelvic pain with discharge or fever.

Pain at the entrance may instead involve dryness, irritated skin, lichen sclerosus or vulvodynia. Genitourinary syndrome of menopause can contribute to dryness when periods have become irregular or stopped. Pain during a period is a symptom, not a diagnosis.

Choose intimacy that does not hurt and stop if pain develops. Try positions that limit depth, move slowly and use lubricant if there is friction. A warm bath or heat pack may ease cramps for some people. Avoid scented products around the vulva. If pain repeats across cycles, record its timing, location, bleeding pattern and other symptoms for a clinician.

Arrange a review for recurring pain, pain between periods, pain that is getting worse or discomfort that affects intimacy. Seek prompt care for fever, foul-smelling discharge, severe pelvic pain, faintness, vomiting, heavy bleeding or pain with possible pregnancy. Bleeding after sex outside your expected period also needs assessment.

Ask whether the pain sounds like cramping, entrance pain or deeper pelvic pain, and whether an examination, infection tests or imaging is appropriate. Discuss endometriosis, ovarian endometrioma, pelvic inflammatory disease, dryness and pelvic floor treatment when relevant.