When should you see a doctor about pain during sex?

Arrange an appointment even without these warning signs if discomfort makes you avoid sex, continues after you change positions or use lubricant, or began after childbirth, surgery, a new medicine, or menopause-related changes.

Pain at the vaginal entrance can be related to dryness, irritation, skin conditions, infection, or pelvic-floor muscles tightening in response to discomfort. Deeper pain may be linked with pelvic inflammation, endometriosis, or an ovarian endometrioma. Genitourinary syndrome of menopause can cause dryness, burning, and tissue changes that make penetration uncomfortable. Lichen sclerosus may cause itching, soreness, or fragile vulvar skin.

Pain during sex is a symptom, not a diagnosis. A clinician may ask where the pain occurs, whether it starts with penetration or deeper movement, and whether it changes with the menstrual cycle. The assessment may include an external examination, a gentle pelvic examination, or tests guided by your symptoms.

Stop or pause any activity that causes pain. You can try more time for arousal, a water-based lubricant, positions that let you control depth, and non-penetrative intimacy. Do not use scented washes or insert products that irritate the area.

Note when the pain started, its location and character, the activities that trigger it, and any bleeding, discharge, urinary symptoms, skin changes, or cycle-related pattern. Pelvic floor physiotherapy or vaginal dilator therapy may be considered for selected causes after an assessment.

Seek urgent medical care for severe or rapidly increasing pelvic pain, heavy bleeding, fainting, a high fever, vomiting, or feeling very unwell. Get prompt advice for pain with a missed period or possible pregnancy, especially if the pain is one-sided or comes with dizziness.

Pain with fever, unusual discharge, or pain when urinating can signal an infection that needs timely treatment. New sores, blisters, or marked swelling also warrant an examination rather than self-treatment.

Ask what might explain the location and pattern of your pain, whether you need an examination or tests, and which treatments are suitable for the suspected cause. You can also ask how to make an examination more comfortable and whether pelvic floor physiotherapy or another specialist could help.