Experiencing pain during sexual intercourse can affect a person’s intimacy and daily life. Describing the pain as “superficial” or “deep” does not establish a diagnosis; but it helps the physician ask the right questions. Pain may be felt at the entrance, around the vagina, in the pelvis, or after intercourse.
What is Superficial Sexual Pain?
Superficial pain is felt at the entrance to the vagina, the vulva, or the tissues around the entrance during penile or other penetration. It can be described as burning, stinging, cutting, tenderness or pain that increases with touch.
In superficial pain, vaginal dryness, irritation, recurrent infections, vulvar vestibulitis, skin diseases and involuntary contraction of the pelvic floor muscles can be evaluated. Intense anxiety or contraction before the pain begins may also be related to vaginismus.
What is Deep Sexual Pain?
Deep pain is pain felt inside the pelvis as penetration progresses or in certain positions. It may be reflected in the lower abdomen, around the uterus, ovarian area or waist area. It is important whether the deep pain occurs in the same way every time during intercourse or only in certain positions.
Endometriosis, ovarian cysts, pelvic infections, some conditions related to the uterus, adhesions after surgery or birth, and pelvic floor problems can be associated with deep pain. This list does not constitute a diagnosis; Evaluation is made through examination and history.
Why is the location of pain important?
Location of pain helps classify possible causes. However, both superficial and deep pain may occur in the same person. Dryness can cause burning at the entrance, and pelvic floor contraction can cause pain both at the entrance and deep.
- Burning or stinging at the entrance: dryness, irritation, infection or vestibular sensitivity
- Contraction before penetration: vaginismus or protective response in the pelvic floor muscles
- Deep pressure or stinging: gynecological or pelvic causes
- Pain that persists after intercourse: infection, muscle spasm or another cause
What Information is Asked in the Evaluation?
The physician may ask when the pain first started, whether it occurs with every intercourse, whether it is felt at the entrance or deep, and whether it is accompanied by dryness or discharge. Its relationship with the menstrual cycle, birth or surgery history, products used and previous treatments are also important.
The examination should be planned in stages, with the person’s consent and feeling safe. If the pain is very significant, the first meeting may start with just talking and planning.
When to Consult a Physician?
If the pain recurs, increases gradually, causes avoidance of sexual intercourse, or is accompanied by symptoms such as discharge, bleeding, fever, burning during urination, a gynecologist and obstetrician should be consulted. Sudden and severe pelvic pain may require urgent evaluation.
For detailed information about painful sexual intercourse, you can review our painful sexual intercourse page .
Frequently Asked Questions
Does superficial pain always mean infection?
No. Dryness, irritation, skin diseases, vestibular sensitivity and pelvic floor contraction can also cause superficial pain.
Is deep sexual pain an important symptom?
By itself, it does not indicate a specific disease; however, recurrent or severe deep pain requires gynecological evaluation.
Does vaginismus cause superficial pain?
In vaginismus, involuntary contraction and pain may occur during penetration attempts. Diagnosis requires the person’s history and appropriate evaluation.
If there is pain during sexual intercourse, should intercourse be continued?
It is not appropriate to sustain the pain by straining. It is safer to understand the cause of the pain, take a break if necessary, and consult a physician.
This article has been prepared for general information purposes. It is not a substitute for examination, diagnosis or personalized treatment advice.
Would you like a personal assessment about this topic?
This website provides general information. Contact the practice on WhatsApp to discuss your concerns and the appropriate next step.
Get information via WhatsApp