Tummy pain during sex

Pain deep in the lower abdomen may reflect irritation or inflammation around the uterus, tubes, ovaries, or bladder. Endometriosis and an ovarian endometrioma can cause deep pain, sometimes with painful periods. Pelvic inflammatory disease may cause pelvic pain with discharge, bleeding, fever, or pain when passing urine.

Pain at the entrance can be linked with vulvodynia, lichen sclerosus, dryness, or tightening of the pelvic-floor muscles. Genitourinary syndrome of menopause can make vaginal tissues drier and more sensitive.

Stop or change the activity when pain starts; continuing through pain can increase muscle guarding. Try slower penetration, more arousal time, lubricant, and positions that limit depth. Keep a note of the location, timing, cycle relationship, discharge, bleeding, and urinary symptoms.

Arrange a gynaecology assessment if pain recurs, affects intimacy, or comes with period pain or fertility concerns. Treatment depends on the cause and may include pelvic-floor care, infection treatment, or laparoscopic excision of endometriosis.

Seek urgent care for sudden severe pelvic pain, faintness, heavy bleeding, fever with worsening pain, repeated vomiting, or pain during a possible pregnancy. Prompt review is also needed for new foul-smelling discharge or bleeding after sex.

Ask whether the pain is superficial or deep, which examination or scan is appropriate, whether infection testing is needed, and how pelvic-floor tension or endometriosis could be assessed.