What should you know about severe abdominal pain during sex?

Pain may be felt at the vaginal entrance, deeper in the pelvis or across the abdomen. Possible causes include pelvic muscle spasm, vaginal dryness, infection, ovarian cyst-related problems, endometriosis or inflammation of the reproductive organs. Conditions such as [Endometriosis](/conditions/endometriosis/), [Ovarian Endometrioma](/conditions/ovarian-endometrioma/) and [Pelvic Inflammatory Disease](/conditions/pelvic-inflammatory-disease/) can present with pain during sex, but the symptom alone cannot identify the cause.

Stop sexual activity, rest and note where the pain started, how quickly it developed and whether penetration or a particular position triggered it. Do not continue through severe pain. Arrange a gynaecology assessment if pain recurs, lasts after sex or affects intimacy. The clinician may ask about periods, discharge, urinary symptoms, contraception and prior pelvic conditions, then decide whether an examination, pregnancy test, swabs or imaging is appropriate.

Seek urgent care for sudden severe pain, fainting, dizziness, fever, vomiting, heavy bleeding, shoulder-tip pain, a rigid or swollen abdomen, or possible pregnancy. These features can signal a problem needing prompt assessment. Pain with fever or unusual discharge also needs timely review for infection.

Ask what conditions fit the location and timing of your pain, whether infection or endometriosis should be checked, and what to do if it returns. Depending on the cause, options may include treatment for [Genitourinary Syndrome of Menopause](/conditions/genitourinary-syndrome-of-menopause/), [Vulvodynia](/conditions/vulvodynia/) or specialist care.