What should you know about vigina pain during sex?

Pain at the entrance may reflect dryness, skin inflammation such as lichen sclerosus, pelvic-floor muscle guarding, or vulvodynia. Deeper pain may occur with endometriosis, an ovarian endometrioma, or pelvic inflammatory disease. Genitourinary syndrome of menopause can make vaginal tissue thinner, drier, and more sensitive. Pain can begin with penetration, occur during deeper movement, or continue afterward; describing the exact pattern helps distinguish possible causes.

Stop or change activity when pain starts rather than pushing through it. A water-based lubricant, more time for arousal, and positions that allow you to control depth may reduce friction or pressure. Arrange a clinical assessment if pain persists, recurs, or affects intimacy. The clinician may examine the vulva and vagina, assess pelvic-floor muscles, test for infection, and consider imaging or referral. Treatment depends on the cause and may include pelvic-floor care or laparoscopic excision of endometriosis when endometriosis is confirmed.

Seek prompt care for severe or sudden pelvic pain, fever, vomiting, unusual bleeding, foul-smelling discharge, sores, or pain with a possible pregnancy. Urgent review is also sensible when pain follows an injury or is accompanied by difficulty passing urine. Recurrent pain without these warning signs still merits an appointment because ongoing guarding can make symptoms harder to break.

Is my pain at the entrance, deeper in the pelvis, or both? Could dryness, a skin condition, infection, or pelvic-floor tension be involved? Do I need infection tests or imaging? What can I do while waiting for treatment?