Pain during sex and BV: what to know

BV is a change in the balance of vaginal bacteria. It commonly causes a thin discharge or a noticeable odour, and some people have irritation; pain during sex can occur when tissue is inflamed, but it is not a defining symptom. Thrush, sexually transmitted infections, pelvic inflammatory disease, dryness, vulvodynia and endometriosis can produce overlapping symptoms. BV does not explain every episode of painful sex.

Arrange a clinical assessment rather than relying on odour or discharge alone to identify BV. A clinician can discuss symptoms and offer an examination or swab when needed. Avoid douching and fragranced washes, and pause penetration if it hurts. If BV is diagnosed, use the prescribed treatment exactly as directed and ask what to do if symptoms return. A partner does not need treatment in every situation, so follow the clinician's advice.

Seek prompt care for pelvic pain with fever, vomiting, faintness, heavy bleeding, or pain when pregnancy is possible. Arrange review for new pelvic pain, pain with urination, sores, unusual bleeding or foul-smelling discharge. Urgent assessment is appropriate when pain is severe or rapidly worsening.

Do my symptoms fit BV, thrush or another infection? Would a swab or sexual-health test help? Could the pain have a separate cause, such as pelvic-floor tension or endometriosis?