Pain in the left abdomen during sex: what to know

Deep penetration can press on the ovaries, uterus or pelvic tissues. Endometriosis can cause pelvic pain that worsens with sex, while an ovarian endometrioma or cyst may cause pain more strongly on one side. Pelvic inflammatory disease may bring lower abdominal pain with unusual discharge, fever or pain when urinating. Vaginal dryness, vulvodynia, pelvic-floor tightness and genitourinary changes after menopause can also make sex painful. Bowel or bladder conditions may feel similar, especially when pain changes with meals, bowel movements or urination.

Pause the activity that triggers pain and note whether it is deep or near the vaginal opening, sudden or aching, and linked to your cycle. Try positions with less depth, slower movement and lubrication if dryness may contribute. Arrange a gynaecology assessment if pain returns, affects intimacy or comes with bleeding, discharge, urinary symptoms or bowel changes. Evaluation may include an examination, pregnancy testing or pelvic imaging depending on your symptoms.

Seek urgent medical care for sudden severe pain, fainting, heavy bleeding, fever, repeated vomiting, a rigid abdomen or pain with a positive pregnancy test. These symptoms can signal a problem needing prompt assessment, including pregnancy-related complications, infection or an ovarian emergency. Contact a clinician soon for persistent pain, pain after sex, bleeding after sex or new discharge.

Could the pain be related to my menstrual cycle, an ovarian cyst or endometriosis? Do I need a pelvic examination, infection tests or an ultrasound? Which symptoms should prompt emergency care?