Pain with Penetration

Share on facebook
Share on twitter
Share on linkedin
Share on email

Pain with any type of penetration, such as from a tampon or from a physical exam, is a symptom of endometriosis. Pain may often be felt with sexual activity. Pain can be from pulling or stretching of tissue. It can also be from pelvic floor dysfunction or other problems with the muscles and ligaments of the pelvic floor. Physical therapy can be useful for this symptom. 

“Dyspareunia is the medical term for pain during sex. It frequently occurs in people with endometriosis because penetration and other movements associated with intercourse can stretch and pull the endometrial growths…. Penetration and other movements related to intercourse can pull and stretch endometrial tissue, particularly if it has grown behind the vagina or lower uterus. Vaginal dryness can also cause this pain. Some means of addressing endometriosis, such as hormonal treatments or a hysterectomy (surgical removal of the uterus), can cause dryness…. Those who do may experience the following:

  • pain that is acute or feels like stabbing
  • pain deep in the abdomen
  • pain ranging from mild to severe

“This pain varies from person to person and may depend on the type of intercourse. Some experience pain only during deep penetration, for example, while others experience pain after sex, rather than during it.” 



  • Melis, I., Litta, P., Nappi, L., Agus, M., Melis, G. B., & Angioni, S. (2015). Sexual function in women with deep endometriosis: correlation with quality of life, intensity of pain, depression, anxiety, and body image. International Journal of Sexual Health27(2), 175-185. Retrieved from 

“The study evidenced that deep endometriosis has a significant impact on sexuality and body image.”

  • Williams, C., Hoang, L., Yosef, A., Alotaibi, F., Allaire, C., Brotto, L., … & Yong, P. J. (2016). Nerve bundles and deep dyspareunia in endometriosis. Reproductive Sciences23(7), 892-901. Retrieved from

“This study provides evidence that neurogenesis in the cul-de-sac/uterosacrals may be an etiological factor for deep dyspareunia in endometriosis.”