Updated

Are you saying "Ouch, stop!" instead of "Oh yes, baby, yes!"?

I’m not talking about a leg cramp, or a side stitch from strenuous and enthusiastic sex. If you're sore and wincing in pain, and it’s not from overexertion, you may need to turn on the light, reach for the phone and make an appointment to get your "equipment" checked — and sooner, rather than later.

For women, erratic pain during intercourse may be as simple as a change in the position of the cervix that happens over the course of a month. But there are other possible causes, all which warrant a visit to the doctor, ASAP:

1. Vaginal Infection

Infections such as thrush or pelvic inflammatory disease can make intercourse painful all the way up the vagina.

2. Endometriosis

This can cause deep pelvic pain during intercourse as well as uncomfortable periods. Endometriosis is common in infertile women.

3. Episiotomy Scar

These scars after childbirth are always painful at first, but the pain should settle within a couple of months.

4. Dryness

This may be due to lack of arousal or lack of estrogen after menopause, or while you are breastfeeding. It can be more pronounced at certain times of your cycle, and it tends to make intercourse painful right from the start of penetration.

5. Vaginismus

This is a spasm of the muscles around the opening of the vagina that makes penetration almost impossible. It almost always has a psychological cause, and is more common if there has been major sexual trauma such as sexual abuse or rape.

For men, pain after ejaculation or sore testicles warrants visiting a doctor who can look for an adrenal or bladder problem. Or it could mean one of the following:

1. Inflammation of the Prostate Gland

If not released, fluid can build up from just fantasizing and dreaming, and compress the gland. Other factors that might come into play are eating too much spicy food, spending too much time bike riding, horseback riding or just plain sitting.

2. Sexually Transmitted Diseases

Chlamydia, gonorrhea and E. coli can cause testicular pain. Make sure you both get tested so as to not ping-pong it back and forth between you.

3. Epididymitis

Swelling of the tube that connects the testicle with the vas deferens can cause tender, swollen groin. Other symptoms include pain during ejaculation or urination.

4. Testicular Torsion

Do your testicles rotate "freely" or sit much lower than expected? Especially common for adolescents, this warrants a trip to the ER to avoid testicular death.

5. Testicular Cancer

Your risk of testicular cancer is roughly 1 in 250. Make sure you're not the one. Pain in the lower abdomen or a feeling of "heaviness" in the scrotum is a symptom.

The good news? Most of these 10 health concerns can be fixed with standard treatment or a prescription. Early prevention and intervention in all of them can make recovery quicker and more effective. Resist the temptation to hope the pain — whether vaginal or testicular — will go away.

Dr. Belisa Vranich is a psychologist and sex expert. She is the author of three books, including her latest "He's Got Potential," which is in stores now. Do you have a "Dear Doc" question? E-mail Dr. Vranich at DrBelisa@gmail.com and check out her Web site at www.drbelisa.com.