Pain in the lower abdomen during sex

Lower abdominal pain during sex can come from pelvic organs, irritated tissues, infection, or tight pelvic muscles. The distinction between pain at the entrance and pain with deep penetration helps guide an assessment.

Deep pain may occur with endometriosis, an ovarian endometrioma, or pelvic inflammatory disease. Endometriosis can also be associated with painful periods, bowel or bladder symptoms, and pain that lingers after sex. Genitourinary syndrome of menopause may cause dryness, burning, and soreness when oestrogen changes affect genital tissues. Lichen sclerosus and vulvodynia more often cause external discomfort, although the whole experience of sex may feel painful.

A symptom does not establish a diagnosis. Your clinician will consider the pain's location, onset, cycle relationship, sexual triggers, and any discharge, bleeding, fever, or urinary change.

Stop when pain begins and avoid pushing through it. Write down when it occurs, how long it lasts, where it is felt, and whether it follows a period or a particular position. A clinician may offer an examination and select infection, pregnancy, or imaging tests according to your symptoms. Management may involve treating infection, easing tissue irritation, supporting pelvic floor relaxation, or treating an identified pelvic condition.

Seek urgent help for severe or rapidly worsening pain, fainting, heavy bleeding, fever, repeated vomiting, or pain when pregnancy is possible. Arrange a medical review for repeated pain, pain after sex that does not settle, bleeding after sex, new discharge, painful urination, or a marked change in periods.

Does the location suggest a pelvic organ, tissue irritation, infection, or muscle problem? Which tests would clarify the cause? Could my period pattern or menopause stage be relevant?