Pain in the side during sex: what to know

Pain felt on one side may come from contact with the cervix or deeper pelvic structures, a particular position, pelvic-floor tightening, or irritation. Vaginal dryness and changes around menopause can make sexual activity uncomfortable. Conditions such as endometriosis, ovarian endometrioma, pelvic inflammatory disease, or vulvodynia may also cause pain. Lichen sclerosus can cause delicate, irritated vulval skin. Genitourinary Syndrome of Menopause may cause dryness, burning, and discomfort with penetration. Pain during sex is a symptom, not a diagnosis.

Stop or change activity when pain begins; continuing through pain can increase guarding and muscle tension. Try slower pace, more lubricant, positions that control depth, and open communication with your partner. Record whether the pain is at entry or deeper, one-sided or central, and whether it follows menstruation. Arrange a gynaecology appointment if pain recurs, causes bleeding, or affects intimacy. A clinician may check the skin, pelvic muscles, cervix, and for infection, then discuss targeted treatment.

Seek urgent help for severe or sudden pelvic pain, fainting, fever, vomiting, heavy bleeding, foul-smelling discharge, or feeling acutely unwell. Prompt assessment is also needed for pain with a missed period or possible pregnancy, or for new pain after a procedure.

Ask what location and timing suggest, whether infection or endometriosis should be considered, and whether pelvic-floor therapy, local treatment, testing, or imaging could help. You can also ask how to keep sex comfortable while assessment is underway.