Pain during sex and endometriosis: talking about it, getting help

Do you have pain during or after sex, and end up avoiding it? Do you wonder whether you’re the problem? It isn’t in your head, and you don’t have to grit your teeth.

Written by Paul, a nurse, founder of EndoQueen. This guide informs; it doesn’t replace an appointment with a health professional.

A common sign, rarely mentioned

The medical word for painful sex is dyspareunia. People rarely talk about it, out of embarrassment or because they’ve come to believe it’s normal. It isn’t.

Being in pain doesn’t mean you lack desire or that your relationship is in trouble. It’s a physical pain, with causes that can be looked for.

At the entrance or deep inside: two different pains

Pain at the entrance (superficial)

Felt at the entrance of the vagina, from the start. It can burn, sting or feel tight. The causes are often different: dryness, infection, irritation, or pelvic floor muscles tightening by reflex.

Deep pain

Felt deep in the pelvis or in the belly, especially in certain positions, sometimes for hours afterwards. This is the one the ESHRE (2022) and NICE (NG73) guidelines list among the signs of endometriosis. It can also occur with adenomyosis.

Both can happen at the same time. None of these pointers can tell you on its own what you have. Your doctor decides.

Talking to your doctor about pain during sex

• You can mention it at the start of the appointment. If it’s easier, write it down and hand over your note.
• Say where (at the entrance or deep inside) and when (at the start, during, after, at certain points in your cycle).
• Mention the other signs: painful periods, painful bowel movements or pain when urinating.
• Say what you’re hoping for: to understand, to be in less pain, to keep a relationship life that suits you.

A gynaecological examination is never compulsory. You can ask for each step to be explained, to stop at any time, or to postpone it.

How to note it

After painful sex, note the pain out of 10, where it was, how long it lasted, and the day of your cycle. Over a few weeks, a link with your period may appear.

Talking to your partner about it

• Choose a calm moment.
• Talk about your body, not the relationship: “It hurts deep inside. It’s not you, it’s a pain I want to get treated.”
• Say what helps: going more gently, taking a break, or doing things differently that day.
• Suggest they come to an appointment, if you both feel like it.

You always have the right to say stop, at any moment, even if you said yes.

The help that exists

• Your doctor or gynaecologist looks for the cause and discusses possible treatments with you.
• A midwife can listen to you and examine you gently.
• A pelvic health physiotherapist helps the pelvic floor muscles relax.
• A sex therapist or a psychologist can support you if the pain weighs on your relationship or your mood.

If you are experiencing violence, local support services and your local emergency number are there for you.

Frequently asked questions

Is it normal to have pain during sex?

No. Pain during or after sex, especially if it keeps coming back, is a sign to mention to a health professional.

What is the difference between pain at the entrance and deep pain?

Pain at the entrance is felt at the opening of the vagina, from the start. Deep pain is felt deep in the pelvis or the belly, often depending on position. Guidelines mainly list deep pain among the signs of endometriosis.

Who can help with painful sex?

Your doctor, a midwife or a gynaecologist, to look for the cause. Depending on your situation, a pelvic health physiotherapist and a sex therapist can also support you.

Read next

• Endometriosis symptoms
• Bowel pain during periods
• Endometriosis and fertility
• All our guides

Sources

• ESHRE, Guideline: endometriosis (2022)
• NICE, Endometriosis: diagnosis and management (NG73)
• AAFP, Adenomyosis: Diagnosis and Management (2022)

Last reviewed: 29 October 2026.