What should you know about severe pain during sex?

Pain may occur at the vaginal opening, deeper in the pelvis, or during and after penetration. Dryness, irritation, tightening of the pelvic floor, infection, skin conditions, endometriosis, or an ovarian endometrioma can contribute. Genitourinary Syndrome of Menopause may cause dryness and fragile tissues around menopause. Vulvodynia can cause burning or pain around the vulva, while Pelvic Inflammatory Disease may cause deeper pelvic pain with discharge or fever.

The pattern matters: note when the pain begins, where you feel it, whether it follows a menstrual cycle, and whether bleeding, urinary symptoms, or discharge occur.

Stop if penetration hurts and choose non-penetrative intimacy while you arrange care. Avoid products that sting, and use a plain lubricant if you try sexual activity again only when comfortable. A clinician may discuss an examination, infection testing, pelvic-floor assessment, or imaging based on your symptoms. Treatment depends on the cause; some people may be referred for pelvic-floor therapy or discussed about Laparoscopic Excision of Endometriosis when endometriosis is confirmed.

Seek urgent care for severe or rapidly worsening pelvic pain, fainting, heavy bleeding, fever with pelvic pain, vomiting, or a possible pregnancy. Arrange a prompt appointment for repeated pain, pain that prevents sex, new bleeding, unusual discharge, sores, or pain after menopause. Do not wait for the pain to become manageable before asking for help.

Could the pain be related to dryness, infection, endometriosis, a skin condition, or pelvic-floor tension? What examinations or tests fit the location and timing of my pain? Which activities are safe while I am being assessed?