Endometriosis symptom check · symptom guide
Deep pain during or after sex (deep dyspareunia)
Clinicians separate pain at the entrance from deep pain: pain felt inside, with deep penetration or certain positions, sometimes lasting hours or a day afterwards. Deep pain is the kind associated with endometriosis. It is also the symptom most often left unsaid, so it goes unrecorded and the picture a clinician sees is incomplete.
Not a diagnosis. This page explains one symptom group that published guidance says should prompt a clinician to consider endometriosis. No symptom, score or checklist can tell you whether you have it; only a clinician can assess you. If pain is severe or sudden, seek medical help.
What the guidelines say
NICE NG73 names deep pain during or after sexual intercourse as a reason to suspect endometriosis. ACOG lists pain during sex among the common symptoms. The Office on Women's Health includes pain during or after sex in its symptom list. All three treat it as a signal in its own right, not a footnote.
How to describe it at an appointment
- That the pain is deep, inside, rather than at the entrance.
- Whether it depends on position or depth.
- Whether it carries on afterwards, and for how long.
- Whether it is worse at certain points in your cycle.
- How long it has been happening and whether it has changed what you do.
What to track before you go
A note on the day is enough: Wrenly's daily log has a notes field, and a pain score for the day it happened. You do not need to log detail you would not want in a report; "deep pain, lasted the evening" is what a clinician needs.
Check your whole pattern
This symptom is one of 14 questions in the free endometriosis symptom self-check. It scores your answers against the six NICE symptom groups and ends in a one-page prep sheet you can print for your doctor. Nothing you enter leaves your browser.
Frequently asked questions
Is pain during sex a sign of endometriosis?
Deep pain during or after sex is one of the symptom groups NICE lists for suspecting endometriosis. It has other causes too, and on its own it is a reason to be assessed, not a diagnosis.
What is the difference between deep pain and pain at the entrance?
Pain at the entrance (superficial dyspareunia) has different common causes, such as skin conditions, infection or pelvic floor tension. Deep pain, felt inside with deeper penetration, is the kind the endometriosis guideline refers to. Say which one you have.
How do I bring this up?
One plain sentence: "I get deep pain during and after sex, worse around my period." Clinicians hear it often. The prep sheet from the symptom self-check includes it as a talking point when your answers point to it.
Sources
- NICE guideline NG73, Endometriosis: diagnosis and management, section 1.3 (when to suspect endometriosis). nice.org.uk/guidance/ng73
- American College of Obstetricians and Gynecologists, Endometriosis patient FAQ. acog.org
- NIH Office on Women's Health, Endometriosis. womenshealth.gov
Wrenly paraphrases these in its own words. It does not reproduce any licensed questionnaire and is not a medical device.
Keep the record in Wrenly
Log pain, bleeding, energy and mood in a tap, paint where it hurts on a body map, and bring a dated symptom PDF to your appointment. Free, private, no account; Wrenly+ adds the doctor PDF and patterns. Not a medical device.