What should you know about pain during sexual arousal?

Pain before penetration can feel sore, burning, aching, or tight. It may come from the vulval skin, vaginal opening, clitoris, pelvic muscles, or deeper pelvis. Genitourinary Syndrome of Menopause can make genital tissue drier and more sensitive. Vulvodynia can cause persistent or triggered vulval pain, while Lichen Sclerosus may cause itching, soreness, or fragile skin. Endometriosis and Pelvic Inflammatory Disease can present with pelvic pain that becomes noticeable with sexual activity. The symptom alone cannot identify one cause.

Notice whether pain is superficial or deep, whether it follows a new product or medicine, and whether discharge, itching, bleeding, urinary symptoms, or cycle-related pain occur with it.

Pause sexual activity when pain starts and avoid pushing through it. A water- or silicone-based lubricant may reduce friction; avoid fragranced washes and products that sting. Arrange a clinician assessment if the pain returns, interferes with intimacy, or comes with unusual discharge or skin changes. Examination may focus on the vulva, vagina, pelvic muscles, and infection testing. Treatment depends on the finding and may include tissue care, pelvic-floor therapy, or targeted treatment for a condition such as Endometriosis.

Seek urgent medical help for severe or rapidly worsening pelvic pain, fainting, heavy bleeding, fever, repeated vomiting, or feeling acutely unwell. Seek prompt care for new bleeding after sex, sores, marked swelling, or pain with a possible pregnancy. These features need assessment because infection, injury, or another urgent pelvic problem may require timely treatment.

Ask: Where does the pain seem to arise? Could dryness, skin irritation, infection, or pelvic-floor tension explain it? Do my symptoms suggest Endometriosis or another pelvic condition? What examination or tests are appropriate? Which lubricant or treatment is suitable for me?