Reasons for Vaginal Pain During Sex

The location and timing of pain offer useful clues. Burning or stinging at the entrance may occur with dryness, skin inflammation, or vulvodynia. Deep pain with penetration can occur when pelvic organs or surrounding tissues are inflamed or tender.

Reduced oestrogen around menopause can thin and dry vaginal tissues; Genitourinary Syndrome of Menopause can present with pain during sex, burning, or soreness. A vaginal or sexually transmitted infection may cause discharge, itching, odour, or pain with urination as well.

Endometriosis can present with deep pain during sex, particularly when pain also occurs around periods. Pelvic inflammatory disease can present with deep pelvic pain during sex, often alongside lower abdominal pain or unusual discharge. Lichen sclerosus can cause fragile, itchy vulval skin that hurts when stretched. Vulvodynia refers to vulval pain without one single underlying cause and may feel burning, raw, or sharp.

Pause penetration when pain starts rather than pushing through it. Note whether the pain is at the opening or deeper inside, whether it follows your menstrual cycle, and whether dryness, discharge, itching, bleeding, or urinary symptoms occur. A water-based lubricant and slower, gentler activity may reduce friction when dryness is contributing.

Arrange a gynaecology or primary-care assessment if the pain returns, affects intimacy, or has no clear short-lived trigger. The clinician may examine the vulval skin and vagina, assess pelvic muscles, and test for infection. Treatment depends on the cause and may include tissue moisturising, treatment for infection, pelvic floor physiotherapy, or care for a specific pelvic condition.

Seek prompt medical care for severe or worsening pelvic pain, fever, faintness, vomiting, heavy bleeding, or pain with a possible pregnancy. Arrange an urgent assessment for new pain with foul-smelling discharge, sores, or marked swelling. Bleeding after sex, repeated pain, or pain that is limiting daily activities also deserves a clinical review.

Could the pain be coming from the vulval skin, vaginal dryness, pelvic muscles, an infection, or a deeper pelvic condition? Which examination or tests would help identify the cause? What can I use safely for symptom relief, and when should I return if the pain continues?