Shooting pain during sex: what should you know?

Pain at the entrance can be linked with dryness, skin inflammation, pelvic-floor muscle tightening or nerve sensitivity. Pain deeper in the pelvis can occur with endometriosis, an ovarian endometrioma, pelvic inflammatory disease or other causes. Genitourinary Syndrome of Menopause may cause dryness and fragile tissues, while lichen sclerosus can affect vulval skin.

A sudden jolt does not identify one diagnosis by itself. A clinician may ask whether the pain is at entry or deep inside, whether it occurs with certain positions, and whether you also have discharge, bleeding, itching, urinary symptoms or cycle-related pain. Pain During Sex provides a useful symptom overview.

Pause penetration when pain begins and do not push through it. Use clear communication, allow more arousal, and consider a water- or silicone-based lubricant if dryness may contribute. Avoid fragranced washes and products that sting. Record timing, location, triggers, cycle pattern and associated symptoms for your appointment.

A clinician may examine the skin, pelvic floor and pelvis, test for infection, or arrange imaging based on your history. Treatment depends on the cause; some people may need pelvic-floor therapy, local treatment, antibiotics or specialist care. Laparoscopic Excision of Endometriosis is relevant only when endometriosis has been assessed and surgery is appropriate.

Seek urgent care for sudden severe pelvic pain, fainting, heavy bleeding, fever, vomiting, a positive pregnancy test with pain, or pain with marked abdominal tenderness. Arrange a prompt appointment for new or persistent pain, bleeding after sex, unusual discharge, genital sores or pain that is worsening.

Ask where the pain seems to arise, whether infection or skin disease should be tested for, whether pelvic-floor assessment is useful, and which treatments are safe with your contraception, pregnancy plans or other medicines.