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Why Does My Stomach Hurt After Sex?

In some cases, stomach pain results from outside stressors or the position you’re in. It could also be a sign of an underlying condition:

Emotional reaction

Sex can stir up all kinds of feelings, ranging from excitement to anxiety, all of which can affect your stomach. Relationship issues, daily stress, and anxiety about sex can cause your abdominal and pelvic muscles to tense up or result in gastrointestinal distress.

Deep penetration

Deep penetration can also cause pain after vaginal and anal sex. This pain is usually temporary and should clear when you change positions or allow your body to rest. You can prevent future pain by trying a different position or avoiding deep thrusting.

Orgasm

Your pelvic muscles contract during orgasm. For some people, these contractions result in painful muscle spasms in the lower abdomen and pelvis. Pain during or after orgasm is also known as dysorgasmia.

Dysorgasmia is more common in people who:

  • are pregnant
  • have ovarian cysts
  • have endometriosis
  • have pelvic inflammatory disease
  • have chronic pelvic pain syndrome
  • have had a prostatectomy

A 2013 study also linked low-dose birth control pills to pain during and after orgasm.

Gas

Penetrative sex can push air into the vagina or anus. If the air becomes trapped, you may experience gas-related pain in your upper abdomen or chest.

Gas pain tends to feel like it’s moving, so this pain may radiate to other areas. Your symptoms should subside once you expel the gas.

Urinary tract infection (UTI)

UTIs typically involve the lower portion of your urinary tract. This includes your bladder and urethra.

Along with pelvic and abdominal pain, you may experience:

  • pain or burning during urination
  • increased urinary frequency
  • cloudy urine
  • bloody urine
  • rectal pain

Sexually transmitted infection (STI)

STIs such as gonorrhea and chlamydia are often asymptomatic. When they do cause symptoms, abdominal pain is possible.

You may also experience:

  • a tender pelvic area
  • pain or burning during urination
  • unusual discharge
  • foul odor

Interstitial cystitis

Also called painful bladder syndrome, interstitial cystitis can cause chronic pain in your pelvis or lower abdomen. This pain may intensify during or after sex.

You may also experience:

  • frequent urination, usually in small amounts
  • feeling like you need to urinate even after emptying your bladder
  • incontinence, or accidental urine leakage

IBS causes a range of gastrointestinal symptoms, including gas and cramping, that can result in stomach pain. Constipation can be especially painful during or after penetrative sex.

Other symptoms of IBS include:

  • bloating
  • diarrhea
  • unusual stool

What causes cramps after sex?

Share on PinterestCramps after sex are more common in women than men.

For women, some possible causes of cramps after sex include:

Deep penetration

Deep penetration, especially against the cervix, can cause irritation and cramping. Injury or infection of the cervix can make it more susceptible to cramping or pain.

Ovarian cysts

The ovaries are two small organs located on either side of the uterus. Sometimes, a cyst grows on or in the ovary.

While these cysts are not usually dangerous, they can cause pain or discomfort after sex.

Ovulation

Each month, one of the ovaries grows a follicle that contains a maturing egg. About 2 weeks before a woman’s period, that follicle ruptures, releasing the egg for potential fertilization and conception.

Having sex around this time can cause abdominal cramping in some people.

Fibroids

Fibroids are growths that occur in the wall of the uterus. They are usually benign, or noncancerous.

They can cause symptoms such as heavy menstrual bleeding and abdominal pain, as well as cramps, after sex.

Vaginismus

Vaginismus occurs when the vaginal muscles involuntarily contract when a person attempts to insert something.

It can happen during penetrative sex and vaginal medical exams, as well as when a person tries to use a tampon.

Although vaginismus can be distressing, it does not always affect whether a person can become aroused and enjoy other types of sexual stimulation.

A person may need to see a sex therapist, who can help them manage anxiety and recommend relaxation exercises.

Pelvic floor exercises may also help treat vaginismus.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection in the female reproductive system.

STIs such as chlamydia or gonorrhea can cause PID, and it can also occur after medical procedures, such as insertion of an intrauterine device.

Endometriosis

Endometriosis is the growth of tissue similar to that which grows in the uterus in places outside of the uterus.

It can cause severe cramping and abdominal pain both during and after sex. Other symptoms of endometriosis include heavy bleeding during menstruation and abnormally painful periods.

Tilted uterus

In some women, the uterus tilts backward instead of leaning forward. The medical term for this is a retroverted uterus.

In people with a retroverted uterus, the penis may put pressure on the uterus during intercourse, which can cause cramps.

If you have pain in the area below your belly button and above your legs, this is known as pelvic pain. A lot goes on in the pelvic area; it’s home to your bowel, bladder, ovaries, uterus (womb) and more. That’s why when you have pelvic pain, it’s important to know the differences between the common causes, to learn what’s normal and what’s not, and when you should seek help.

Persistent pelvic pain, also known as chronic pelvic pain, is pain that is present on most days for six months or more. Jean Hailes gynaecologist Dr Janine Manwaring explains that, for women with persistent pelvic pain, the journey to getting the right diagnosis can be a bumpy one.

When it comes to persistent pelvic pain, Dr Manwaring says there is a lack of education, both within the medical community and the general community.

“There are many misconceptions about pelvic pain, particularly period pain,” she says. “Pain can be downplayed by both doctors and by other women within the family. A lot of it comes down to getting the right information and knowing who the right people are to get in touch with.”

So here are some of the conditions that can cause persistent pelvic pain, as well as tips on how to spot the differences between them and when you need to see a trusted doctor.

Period pain

Period pain is a very common experience for women and girls; the research varies a lot on just how widespread it is, but one Australian study found it affects 93% of female senior high-schoolers.

The pain occurs when the muscles in the uterus (womb) contract or tighten, and often feels like cramping or heaviness in the pelvic area, lower back or stomach. Despite it being a typical add-on of getting your period, if the pain is severe, it could be a sign of something more serious, such as endometriosis.

“If your period pain lasts longer than the first one or two days of your period, if it does not improve with period pain medications and/or the Pill, or if it’s stopping you from going about your life, then you should see your GP,” says Dr Manwaring.

Read more about period pain.

Endometriosis

Endometriosis (pronounced end-o-me-tree-oh-sis) is a condition that affects a woman’s reproductive organs and is commonly associated with pelvic pain.

In endometriosis, cells that are similar to those that line the uterus (the endometrium) grow in other parts of the body – typically in the pelvic area such on the bowel, bladder or ovaries.

These cells undergo the same menstrual changes as those inside the uterus, but unlike period blood, have no way of escaping, so they build up, causing problems such as pain, scarring and inflammation.

Three out of four women with endometriosis experience pain, and this pain can occur immediately before your period, during your period, or during or after sex. Pain can be felt in the pelvis, stomach, back, when passing wind, urine or stool (poo), or when you ovulate.

Read more about endometriosis.

Adenomyosis

Often referred to as the ‘sister’ condition of endometriosis, adenomyosis also involves problematic cell growth. Instead of these endometrium-like cells growing on parts of the body such as the bowel or ovaries as they do in endometriosis, in adenomyosis, the cells grow into the muscle wall of the uterus.

Symptoms of adenomyosis can be quite similar to endometriosis and include abnormal or heavy menstrual bleeding, painful periods (often after years without pain) and painful sex.

Read more about adenomyosis.

Irritable bowel syndrome (IBS)

The exact cause of IBS still not 100% clear, but it is thought that the muscle wall of the bowel becomes sensitive and contracts unevenly, resulting in pain and bloating. This type of pelvic pain typically improves after passing wind or stool (poo) and is often managed by avoiding potential food triggers and reducing stress.

“However, if you see blood in your stool , or if you experience extreme diarrhoea, incontinence or unexplained weight loss, see your GP,” says Dr Manwaring.

Read more about IBS.

Pelvic muscle pain

Dr Manwaring explains that pelvic muscle pain can feel like you have an ongoing cramp in your pelvic area most of the time. “The pain can also be sharp or stabbing and shoot up the vagina or rectum,” she says. “You might have pain with sex or using tampons, which can last for hours afterwards.

“Pelvic muscle pain often gets worse with exercise, especially core-strengthening exercises such as pilates, sit-ups or crunches. Women can often find some relief by lying in the foetal position, using a heat pack, doing pelvic muscle stretches (visit pelvicpain.org.au) and seeing a pelvic floor physiotherapist.”

Bladder pain & urinary tract infections (UTIs)

Affecting more than 50% of all women during their lifetime, another common cause of pelvic pain are UTIs. The pain typically experienced with a UTI occurs when passing urine; a burning sensation and/or lower abdominal pain.

Although UTIs are common, if left untreated they can develop into more serious kidney infections. If your symptoms persist for more than 24 hours and include fever, chills, back pain, nausea or vomiting, you should see your doctor immediately.

Read our guide to UTIs.

The other common type of bladder pain is called interstitial cystitis (also known as painful bladder syndrome). This type of pain is different from a UTI in that there is irritation, but no infection.

Painful bladder syndrome is common in women with endometriosis.

Dr Manwaring advises you to see your GP if you have troublesome bladder symptoms that are persistent or frequent, including:

  • needing to empty your bladder more than 8-10 times during the day
  • needing to empty your bladder more than once a night
  • pain with full bladder, which improves with emptying
  • pain with intercourse
  • a sense of urgency to urinate.

Read more on bladder pain on the Pelvic Pain Foundation website.

Vulval pain

Vulval pain can occur due to irritation and inflammation of this sensitive body part – and not just due to candida (thrush), as is commonly believed. There are many different causes of vulval irritation, and ways to manage it.

Read more on vulval irritation.

Vulvodynia (pronounced vul-vo-din-ia) is a condition in which there is pain, discomfort or a burning sensation in the vulva that cannot be linked to a specific cause. The pain associated with vulvodynia may or may not be triggered by touch, it may be felt in one area of the vulva or across the whole area.

Vulvodynia is a chronic condition that can last for months or years. For some women, the pain can be so severe that using tampons, having sex or even sitting down for long periods is very difficult or impossible.

Read more on vulvodynia on the Royal Women’s Hospital website.

Key advice for persistent pelvic pain

In what can be a confusing time for women, Dr Manwaring offers five key pieces of practical advice for women with persistent pelvic pain.

  1. If you feel as if you’re not being listened to by your current doctor or health professional, don’t be afraid to seek a second opinion.
  2. A multidisciplinary team has been shown to be the best approach in managing persistent pelvic pain. Chronic pain is not just about the immediate pain, but also involves and affects multiple areas of health and life, so coming at it from different angles and treating the whole person is crucial.
  3. Keep track of your symptoms in a form that is easy and accessible for you. Jean Hailes has an excellent Period pain & symptom diary that you can download for free. Having your symptoms and treatments written down can help a lot when talking to different health professionals and helps to assess if/when progress is being made.
  4. Source reliable health material and self-care strategies. There is a lot of information on pain management on the internet and in chat forums. Try to focus on advice and information that is based on evidence and comes from a reliable source.
  5. Always remember that you are not alone. Sometimes pelvic pain conditions can be difficult to manage and it can feel like other people can’t relate to it because your pain cannot be seen. But don’t feel like you can’t seek help for it; there are people who will listen to you and take you and your symptoms seriously.
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The topic of pain during or after intercourse isn’t frequently discussed, despite the fact that it’s not uncommon. A British survey that found that roughly 1 in 10 women experiences pain during sex. In particular, many women experience cramping or abdominal pain during or after sex, and so Allure spoke with doctors to about what causes it — and what to do about it.

As far as the causes of such pain, Raquel Dardik, a clinical associate professor of obstetrics and gynecology at NYU Langone Medical Center, says there are several possible causes. One is connected to ejaculation: Semen contains a molecule called prostaglandin, and if a woman is sensitive to it, its release into the vagina during ejaculation could result in cramping afterward. “Another possibility is that the bladder gets irritated from the friction during intercourse; that can also feel like cramps after intercourse,” Dardik adds. She also notes that that organs such as the ovaries or the uterus may get jostled or hit during intercourse in a way that potentially leads to pain during or after sex.

Dardik says to consult a doctor if your pain is ongoing and severe, especially if it’s a persistent problem after sex. She recommends emptying your bladder before sex, using a condom to remove ejaculation from your pain equation, and trying different positions and pacing to see if that improves the situation. (It’s also important to check in with yourself and your partner during the act and communicate how you’re feeling.)

Another big question people have about pain after sex is when it is severe enough to warrant immediate medical attention, when a doctor should be consulted at a later time, and when it will go away on its own. If the pain disappears within a matter of minutes, it’s unlikely to need an immediate evaluation, says Megan Ranney, an emergency physician and the director of Brown University’s Emergency Digital Health Innovation program. “The big test for me as an emergency physician is if something goes away,” she says. “If you’re in 10-out-of-10 pain and it’s getting worse or it’s continuing after more than 10 or 15 minutes, you should get checked out. The other question is, is this something that’s happened before?” Repeated occurrences warrant a check-in with a medical professional. Ranney adds that while emergency rooms can help with urgent pain, however, people who consistently experience abdominal pain or cramps after sex should see a gynecologist to receive more detailed tests and treatment.

When a patient comes into the emergency room with pain after sex, Ranney asks a number of questions to diagnose the problem, including:

  1. Has this type of pain happened before?
  2. At what point during sex did the pain begin?
  3. How long has the pain lasted?
  4. Is there anything else that causes similar types of pain?
  5. What was the patient’s last period?

Ranney will also ask about patient’s history with urinary tract infections, sexually transmitted infections, vaginal bleeding and discharge, and domestic violence or sexual assault, all of which can be related to pain in the abdominal region.

The bottom line: There are many reasons you could be experiencing cramping or abdominal pain after getting it on. When in doubt (or a lot of pain), seek the advice of a medical professional — you deserve to feel comfortable during and after intercourse.

More about sex:

  1. Rubber Robbers Steal 30,000 Condoms and $10,000 of Sex Toys
  2. Why I Bought Myself a Promise Ring When I Was 12 Years Old
  3. These Sex Toys Will Give You an Out-of-This-World Orgasm

8 Reasons You Might Be Feeling Pain After Sex

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In ~fantasy land~, sex is all orgasmic pleasure (and none of the consequences!) while post-sex is all cuddles and afterglow. But for many people with vaginas, pain after sex and general discomfort are surprisingly (and unfortunately) common.

“More than one-third of people will vulvas will experience pain after penetrative sex at some point in their lifetime,” says Kiana Reeves, a Somatic sex expert and sex and community educator with Foria Awaken, a company that creates products intended to reduce pain and increase pleasure during sex. (Pssst: They make a pretty awesome lube/arousal oil that has weed in it.)

“So, so many many many people come to see me for that reason,” agrees Erin Carey, M.D., a gynecologist who specializes in pelvic pain and sexual health at the UNC School of Medicine.

There’s a surprising variety of possible reasons for having pain after sex. “But while there are many potential causes for painful intercourse, most of them can be remedied with treatment,” says Reeves. Phew.

In order to resolve the pain, first, you have to understand the underlying cause. Here, experts break down the most common reasons you might experience pain after sex. (If any of these symptoms sound familiar, call your doc.)

1. You need a better warm-up routine.

During sex, it should never feel like you’re trying to fit a square peg into a round hole. “Women can fit a 10 cm baby head through the vaginal canal without it tearing; it’s pretty elastic,” says Steven A. Rabin, M.D., FACOG with Advanced Gynecology Solutions, Inc in Burbank, California. For the vagina to become elastic, though, you need to be turned on. “It’s part of the female sexual response,” he explains.

If your body isn’t adequately primed for sex, penetration might not be possible at all, or the over-tightness can lead to too much friction during sex, causing micro-tears in the vaginal wall. In this case, you might feel “a stingy, raw sensation internally” during sex, says Reeves.

Then, if the inside surface of your vagina feels raw or sore and in pain after sex, you may just need more foreplay and/or lube before attempting penetration. Instead of doing trial and error, Reeves suggests touching the labia pre-insertion. The firmer it feels to the touch, the more turned on you are. (Related: What Happens When You’re Really Turned On)

It’s worth noting that some women can only tolerate penetration after an orgasm because then the muscles are more relaxed and your body is more primed for entry, explains Dr. Carey. “Other women could have a high-tone pelvic floor and may need to learn how to relax the vagina before penetration,” she says. Consider seeing a pelvic floor therapist who can give you exercises that will train those muscles to relax enough in order for penetration to 1) happen at all 2) happen without the excessive friction or pain mentioned above, she says.

Another possibility is chronic vaginal dryness, says Dr. Carey. If extra foreplay isn’t helping, check with your doc. (See more: 6 Common Culprits of Vaginal Dryness).

2. You have BV, a yeast infection, or a UTI.

“These three issues can cause sexually active individuals a great deal of pain around sex and often unwarranted worry,” says Rob Huizenga, M.D. an LA-based celebrity physician, sexual health expert, and author of Sex, Lies & STDs. While they’re all super common, the pain that each causes during and after sex is a little bit different.

Bacterial Vaginosis (BV): When BV (an overgrowth of bacteria in the vagina) is symptomatic, it usually comes with a strong, fishy odor and thin, discolored discharge. Again, you may not ever want to have sex when your vagina smells off, but if you do… ouch! “It’s going to cause inflammation to the vaginal mucosa, which is going to get further irritated from sex,” explains Dr. Carey. “Any irritation in the pelvis can also cause the pelvic floor muscles to spasm in response.” These spams can create a throbbing or pulsating sensation that’s uncomfortable and leaves you with pelvic pain after sex. Fortunately, BV can be cleared up with a prescription from your doctor.

Yeast Infection: Caused by the candida fungus, yeast infections often present with “cottage cheese” discharge, itching around the pubic area, and generalized soreness in and around your nether-bits. Basically, sex and yeast infections are about as compatible as Ariana Grande and Pete Davidson. So, if you find yourself doing the dirty when you have one, it’s probably going to be uncomfortable. “Because yeast infections cause the localized tissue in the vagina to become inflamed,” explains Dr. Carey. Combine the friction of penetration with the preexisting inflammation, and it’ll certainly exacerbate any pain or irritation. In fact, Dr. Barnes says the inflammation can be on the inside or the outside, so if your labia look redder after the fact, that’s why. Thank u, next. (Pro tip: follow this Step-By-Step Guide to Curing a Vaginal Yeast Infection before heading South.)

Urinary Tract Infection (UTI): A UTI happens when bacteria gets lodged in your urinary tract (the urethra, bladder, and kidneys). Granted, you’re probably not going to be in the mood if you have a UTI, but if the opportunity comes knocking and you chose to partake, it’s going to feel less than amazing. “The bladder lining gets irritated when you have a UTI, and because the bladder lies on the front wall of the vagina, penetrative intercourse can agitate an already irritated area,” explains Dr. Carey. “As a result, the pelvic floor muscles, (which surround the vagina and bladder), can spasm, resulting in secondary pelvic pain after sex.” Luckily, an antibiotic can clear the infection right up. (Related: Can You Have Sex with a UTI?)

3. You have an STI or PID.

Before you freak out, know that “STI’s are not known for causing pain during or after sex,” according to Heather Bartos, M.D., an ob-gyn in Cross Roads, Texas. Still, some STI’s may lead to pain after sex, especially if they go undetected and untreated for a long time.

Herpes is the STI most classically associated with pain, says Dr. Bartos. “It can present with painful genital or rectal ulcers, sores, or skin breaks that can be extremely painful and uncomfortable not only during and after sex, but also in regular life.” All experts offer the same advice: If you’re in the middle of a herpes outbreak, don’t have sex. Not only do you risk transmitting the infection to your partner, but sex can cause those external sores to open or enlarge and become even more tender until they heal. (Related: Here’s How to Get Rid of a Cold Sore In 24 Hours). Plus, since the herpes virus lives in the nerves, it also results in chronic nerve pain, says Courtney Barnes, M.D., an ob-gyn with University of Missouri Health Care in Columbia, Missouri.

Other STI’s like gonorrhea, chlamydia, mycoplasma, and trichomoniasis can also lead to pain during and after sex if they’ve developed into pelvic inflammatory disease (PID), says Dr. Huizenga. “It’s an infection of the reproductive tract and gut—specifically the uterine, tubal, ovarian, and intra-abdominal lining—that causes them to be inflamed.” A hallmark sign of PID is what doctors call the “chandelier” sign, which is when barely touching the skin above the cervix causes pain.

Sex or not, “people can actually become quite ill from this disease as it progresses; it can cause significant abdominal pain, fever, discharge, nausea/vomiting, etc. until it’s treated,” says Dr. Barnes. The solution? (Bless, there is one!) Antibiotics. (Note: Any vaginal bacteria can ascend and cause PID, not just sexually transmitted infections, so don’t jump to conclusions—unless, of course, you’re experiencing other symptoms of STIs.)

And friendly PSA: Most STI’s are asymptomatic (like these Sleeper STDs You’re at Risk For), so even if you’re not experiencing the symptoms mentioned above, don’t forget to get tested every six months, or between partners, whichever comes first.

4. You’re having an allergic reaction.

If your vagina feels irritated or raw, swollen, or itchy after intercourse (and that goes internally or externally), “it could be an allergy or sensitivity to your partner’s semen, the lubricants, or the condom or dental dam,” says Dr. Carey. Semen allergies are rare (research shows only 40,000 women in the US are allergic to their SO’s semen), but the solution here is to use a barrier to avoid exposure, she says. Makes sense. (Related: Should You Be Using Organic Condoms?).

On the other hand, according to Reeves, latex allergies and sensitivities to your lube or sex toy are pretty common. If you have a latex allergy, there are animal skin condoms or other vegan options, she says.

As for lubes and toys, if there are any ingredients you can’t pronounce, just say no! “Generally, water-based lubricants are less irritating,” says Dr. Carey. “Some women who are particularly sensitive will use natural oils such as olive oil or coconut oil as a lubricant during intercourse.” Just note that the oil in these natural options can break down the latex in condoms and make them ineffective. (Related: How to Tell If Your Sex Toys Are Toxic).

If none of these solutions appeal to you, you can visit an allergist for allergy skin testing to see what the exact allergen is, says Dr. Bartos. (Yes, they can even do this with semen, she says.)

5. You have vaginismus.

For most women and folks with vaginas, when something—be it a tampon, a speculum, finger, penis, dildo, etc.—is about to be inserted into the vagina, the muscles relax to accept the foreign object. (“Alexa, relax vaginal muscles.”) But for people with this little-known condition, the muscles aren’t able to relax. Instead, “the muscles have involuntary contractions which tighten the entry to the point where penetration is either impossible or downright painful,” explains Dr. Rabin.

Even after attempted penetration, the vagina can tighten and clench in anticipation of more pain, explains Dr. Barnes, which in itself can be painful and lead to prevailing muscular soreness, not to mention cause lasting pain after sex. (Related: The Truth About What Happens to Your Vagina if You Haven’t Had Sex in a While).

There isn’t one cause of vaginismus: “It could be caused by a soft tissue injury from sports, sexual trauma, childbirth, inflammation in the pelvic floor, infection, etc.,” explains Reeves.

It’s often thought to part psychological and physical (as most things are!). “It’s like the vagina is trying to ‘protect’ the person from further trauma,” says Dr. Bartos. That’s why she and Reeves recommend seeing a trauma-trained pelvic floor physical therapist who can work with you release these muscles and address the underlying cause, if there is one. “I suggest a hands-on sex and pelvic floor therapist, if you can find one,” says Reeves.

6. Your ovarian cysts are bugging you.

Ready to have your mind blown? Every vulva-owner of reproductive age who’s not on birth control makes an ovarian cyst during ovulation every single month, explains Dr. Carey. Woah. Then, these cysts rupture to release the egg without you ever knowing one was hanging out in there.

However, sometimes these fluid-filled sacs cause pain—specifically in the right or left side of the abdomen, where the ovaries are. (Hellooo, cramps!) According to experts, there are three main reasons why.

First, the actual rupture might cause an uncomfortable ache or abdominal pain. Second, while the fluid from the popped cyst will get reabsorbed by the body within a few days, “it can cause irritation of the pelvic peritoneum (the thin membrane that lines the abdomen and pelvis) making your vaginal canal sensitive, and intercourse painful before it’s fully absorbed,” says Dr. Carey. In both cases, you may have pain before, during, and after sex. But don’t think “well, if it’s going to hurt anyway, I might as well” because, having sex “can cause an inflammatory response in the pelvis which often leads to worse pain after sex,” she explains.

Knowledge is power here: “Every month, you’ll know that there’s a day or two where sex in a certain position might hurt,” says Dr. Rabin. “Make an adjustment and change the angle of attack.” Or, just leave sex for the other 29 days a month. (Related: This Actress Was Hospitalized for a Ruptured Ovarian Cyst).

Sometimes though, these cysts don’t rupture. Instead, “they grow and grow and become painful, especially during penetration,” explains Dr. Rabin. And, yep, they can cause pain after sex, too. “The penetration causes a blunt trauma inside you that hurts even after the fact.”

Your ob-gyn can perform an ultrasound to diagnose whether or not that’s actually what’s causing your pain. From there, “they can be monitored, or you can go on a birth control pill, ring, or patch,” he says. Occasionally, he says, they may require surgical intervention. While this news sucks and nobody likes thinking about going under the knife, think about all the pain-free sex you can have after!

7. You have endometriosis.

Chances are, thanks to Julianne Hough and Lena Dunham sharing their struggles, you’ve probably at least heard of endometriosis—if not know someone who suffers from it. ICYDK, it’s a condition where “menstrual tissue cells implant and thrive elsewhere in the body—typically in your pelvis (such as the ovaries, Fallopian tubes, intestines, bowels, or bladder),” explains Dr. Rabin. “This misplaced menstrual tissue swells and bleeds, causing an inflammatory response and sometimes scar tissue.” (See more: The Endometriosis Symptoms You Need to Know About).

Not everyone with endometriosis will experience pain during sex or pain after sex, but if you do, inflammation and/or scarring are usually the culprits. By now, you know inflammation=pain, so it shouldn’t be surprising that’s why there’s pain during and/or after sex.

But, “in some severe cases, the scarring response is extensive, and penetrative intercourse can create a sensation that the vagina, uterus, and surrounding pelvic organ are being pulled,” says Dr. Barnes. And if that’s the case, she says the pain—which could include anything from slight soreness to an internal stabby sensation or burning—can linger after sex too. Ugh.

For some patients, sex and its aftermath will only be painful around their menstrual cycle, says Dr. Carey, but for some folks, sex is painful every day of the month. “Endometriosis doesn’t currently have a cure, but the next step is to see a physician who understands the pathophysiology of the disease because medication and surgery can help manage symptoms.” (Related: How Much Period Pain Is Normal).

8. You’re going through some ~hormonal changes~.

“During menopause and right after you’ve given birth, there’s a decline in estrogen,” explains Reeves. A decrease in estrogen leads to a decrease in lubrication. ICYDK, when it comes to sex, the wetter the better. So, this lack of lube can result in less pleasant sex and pain after sex, since your vaginal canal may actually feel raw and chafed. Dr. Carey says the best fix here is a combination of lube and vaginal estrogen therapy.

The bottom line: Sex is *not* supposed to be painful, so if you’re experiencing pain after sex, talk to your doctor about it. “Figuring out the exact cause of pain after sex may take a little bit of patience because there are actually so many other possible causes of painful intercourse,” on top of those already discussed says Dr. Barnes. Some less-common reasons include lichens sclerosis (a common genital skin condition in post-menopausal women), vaginal atrophy (the thinning, drying, and inflammation of the vaginal walls that occurs when your body has less estrogen), thinning of the vaginal walls, internal scarring or adhesions, Interstitial Cystitis (a chronic bladder pain condition) or even a disruption of vaginal flora—but your doc should be able to help you figure out what’s up.

Remember though, “in most, cases treatment is available and can help make sex enjoyable again!” says Dr. Barnes.

“So many women experience pain during and after sex, but don’t know that isn’t a normal thing,” adds Reeves. “I wish I could tell everyone that sex should only be pleasurable.” So, now that you know, spread the word. (Oh, and FYI, you also shouldn’t be experiencing pain during sex, either).

  • By Gabrielle Kassel

From period cramps to childbirth and fuckboys to UTIs, women already have a lot of painful BS to deal with. And sex? Well, that’s one thing women should not feel pain before, during, or after.

And yet, lots of women experience cramps for minutes, hours, days, and sometimes even weeks after sex. If you’re one of these women, you’ve come to the right place.

We spoke to two amazing doctors about everything there is to know about post-sex cramps. Read along and get ready to conquer your cramps once and for all.

Are post-sex cramps normal?

Simply put? No. “Any pain is not normal—although that doesn’t mean something dire is happening, it just means you may need an evaluation,” says Felice Gersh, MD, founder and director of the Integrative Medical Group of Irvine and the author of Pcos SOS: A Gynecologist’s Lifeline to Naturally Restore Your Rhythms, Hormones, and Happiness.

If you’re experiencing cramps after sex regularly, it’s time to schedule an appointment with your gyno to get things checked out.

Cosmopolitan

Why do they happen?

There are lots of reasons why women experience cramps after intercourse. “Pain with or after intercourse (called dyspareunia) alerts me to a couple of possible underlying conditions or diseases,” says ob-gyn Kimberly Langdon, MD, a medical advisor at Dr Felix, a digital health company based in Europe and California.

A few possible reasons?

Endometriosis—a disease related to menstruation where tissue that grows on the lining of the uterus grows outside of the uterus (where it shouldn’t). Adenomyosis—endometriosis found inside the muscle portion of the uterus. Fibroid tumors—benign muscle tumors of the uterus. Pelvic inflammatory disease—when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes, or ovaries. Ovarian cysts—fluid-filled sacs in the ovary. Urinary tract disease—infection in any part of your kidneys, ureters, bladder, and urethra. Irritable bowel syndrome—a disorder that affects the large intestine and causes cramping, abdominal pain, bloating, gas, and diarrhea or constipation.

“It may also be possible for a woman who is ultra-sensitive to oxytocin to experience cramps after sexual intercourse,” says Dr. Langdon.

Dr. Gersh also notes that emotional pain can cause you to experience physical cramps after sex. “Another area that is often overlooked but can be the underlying cause of sexual pain is a history of sexual trauma,” she explains.

“Women who have experienced such things in their lives may inadvertently tighten their pelvic-floor muscles and this can result in very painful cramping with and following sexual activity.”

Related Story

Where do post-sex cramps typically occur?

According to Dr. Langdon, post-sex cramps typically happen in your “low suprapubic” area, meaning the front bone of the pelvis. That being said, they can be so deep that they actually radiate to your lower back and upper thighs.

When should you see a doctor?

Dr. Gersh urges you to consult with your ob-gyn “right away” if you’re experiencing post-sex cramps. If the doctor doesn’t find anything physical going on, she suggests going to both a mental-health therapist and a pelvic-floor therapist to help figure out if there are any emotional issues at hand.

What can you do to avoid them?

The first thing you have to do is go to the doctor where you can be treated with any necessary medications or treatments.

If you don’t have underlying pelvic diseases and are still experiencing cramps, Dr. Langdon recommends trying any of the following over-the-counter drugs an hour before intercourse, then again right after to help avoid the pain:

Ibuprofen Naproxysn Ketoprofen Fenoprofen Piroxicam Indomethocin

Dr. Langdon also suggests the following natural remedies for the pain:

Omega 3 fatty acids Magnesium Bark of viburnum Acupressure Massage Abdominal heat packs Calcium Vitamin E Related Story Candice Jalili Candice is a Sex, Relationship, & Lifestyle Writer based in NYC.

What causes pelvic pain in women?

1. Menstrual pain and cramps

Share on PinterestMenstrual cramping is a common cause of pelvic pain.

Menstrual pain and cramping are a common cause of pelvic pain in women.

Of all menstrual disorders, women most commonly report experiencing pain, say the American College of Obstetricians and Gynecologists (ACOG).

Over half of women who menstruate will experience some pain for at least 1–2 days each cycle.

Menstrual cramping will typically occur immediately before a woman starts her period, as the uterus contracts and sheds its lining. The pain may feel similar to a muscle spasm or a jabbing pain.

Using a warm heat pad may relieve the sensation. Over-the-counter medications, such as ibuprofen (Advil) and naproxen (Aleve), may also help relieve pain.

In cases of severe pain from menstruation, doctors can recommend other medications.

2. Ovulation

If a woman feels a painful sensation on one side of her pelvis in the middle of her menstrual cycle, she may be experiencing mittelschmerz. Doctors use this German word to describe painful ovulation.

When a woman ovulates, the ovaries release an egg, along with some other fluid. The egg will then travel down the fallopian tube and into the uterus. The fluid released by the ovary can spread within the pelvic area, sometimes, causing irritation in the pelvis and leading to pain.

The discomfort may last for minutes or hours, and it may switch sides of the body, depending on which ovary released the egg. The pain is temporary and requires no specific treatment.

3. Interstitial cystitis

It is also possible for a woman to experience ongoing bladder inflammation that has no known cause. The medical term for this is interstitial cystitis, and doctors are currently unsure why it happens.

Interstitial cystitis can cause pelvic pain and symptoms such as painful urination, needing to urinate frequently, and pain during sex. Treatment often involves managing symptoms as best as possible.

4. Cystitis or urinary tract infections

Cystitis refers to inflammation in the bladder due to a bacterial infection. This happens because vaginal, rectal, or skin bacteria can enter the urethra and make their way to the bladder.

A urinary tract infection (UTI) is one that can occur anywhere in the system, while cystitis occurs only in the bladder.

Both conditions are common in women. These infections will sometimes clear up on their own, but a short course of antibiotics will typically treat cystitis and other UTIs.

5. Sexually transmitted infections

Share on PinterestA sexually transmitted infection can cause pelvic pain.

Pelvic pain may indicate the presence of a sexually transmitted infection (STI) such as gonorrhea or chlamydia. STIs occur in people who are sexually active.

Chlamydia affects around 2.86 million people each year in the United States, according to the Centers for Disease Control and Prevention (CDC).

The CDC also estimate that gonorrhea affects 820,000 people every year.

Along with pelvic pain, other symptoms of STIs may include painful urination, bleeding between periods, and changes in vaginal discharge.

Anyone experiencing these changes should see their doctor who will be able to diagnose an STI and prescribe treatment, usually including antibiotics. It is also critical to inform sexual partners about the infection to prevent it from spreading.

6. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an infection in the womb that can damage the surrounding tissue. PID can arise if bacteria from the vagina or cervix enter the womb and take hold.

It is usually a complication of an STI such as gonorrhea or chlamydia. Along with pelvic pain, women may experience other symptoms, including abnormal vaginal discharge and bleeding.

PID increases a woman’s risk of infertility. The CDC note that 1 in 8 women who have had PID also have trouble becoming pregnant.

Treatment typically involves taking antibiotics to treat the bacterial infection. However, they cannot treat scarring, which is why early treatment is crucial.

7. Endometriosis

Endometriosis occurs when endometrium, or tissue that lines the inside of the uterus, grows outside of the womb.

Endometriosis may be a source of chronic, long-lasting pelvic pain in some women. When a person’s period begins, this tissue outside of the uterus responds to hormonal changes, which may cause bleeding and inflammation in the pelvis.

Some people may experience mild to severe pain. Endometriosis may make it difficult for some women to become pregnant. Doctors may recommend various treatments, depending on symptom severity.

8. Irritable bowel syndrome

Irritable bowel syndrome (IBS) is a gut disorder that causes pain and symptoms, including constipation, diarrhea, and bloating.

The symptoms of IBS tend to flare up and go away over time, especially after a bowel movement. There is no cure for IBS, so treatment focuses on managing symptoms through changes in diet, stress levels, and medications.

9. Appendicitis

Appendicitis is inflammation in the appendix, which is a small organ in the lower-right abdomen. An infection causes this condition, and, although it is common, it can be severe.

Anyone experiencing a sharp pain in their lower-right abdomen, along with other symptoms such as vomiting and fever, should seek immediate medical care, as this may be a sign of appendicitis.

10. Urinary stones

Stones in the urinary tract consist of salts and minerals, such as calcium, that the body has trouble getting rid of in the urine.

These minerals can build up and form crystals in the bladder or kidneys that often cause pain in the pelvis or lower back. Stones may also cause the urine to change color, often turning it pink or reddish with blood.

Some stones do not require treatment, but passing them can be painful. At other times, a doctor may recommend medications to break up stones or surgery to remove them.

11. Ectopic pregnancy

An ectopic pregnancy occurs when an embryo implants itself anywhere outside of the uterus and starts growing.

A woman may feel very sharp pain, and cramps in her pelvis, which are usually focused on one side. Other symptoms include nausea, vaginal bleeding, and dizziness.

Anyone who suspects that they have an ectopic pregnancy should seek immediate medical care, as this is a life-threatening condition.

12. Pelvic adhesions

An adhesion is scar tissue that occurs inside the body and connects two tissues that should not be connected. This may result in pain, as the body struggles to adapt to the adhesion

The scar tissue could form due to an old infection, endometriosis, or other issues in the area. Pelvic adhesions may lead to chronic pelvic pain in some women, and they may cause other symptoms, depending on where the scar tissue appears.

A doctor may recommend some minimally invasive surgeries to help reduce adhesions and relieve symptoms.

13. Ovarian cysts

Ovarian cysts occur when the ovaries fail to release an egg. The follicle holding the egg may not open completely to release the egg, or it may become clogged with fluid.

When this happens, a growth called a cyst forms in the area, which may cause bloating, pressure, or pelvic pain on the side of the body with the cyst.

As the ACOG explain, most cysts are noncancerous. In many cases, ovarian cysts go away on their own. In some cases, a cyst may bleed or burst, which can cause sharp, severe pain in the pelvis and may require medical treatment.

Doctors can identify ovarian cysts using ultrasound, and they may recommend treatments that range from watchful waiting to surgery.

14. Uterine fibroids

Fibroids are lumps of muscle and fibrous tissue within the uterus. While they are noncancerous and do not tend to cause symptoms, these growths can be a source of pain. They may cause discomfort in the pelvis or lower back or pain during sex.

Fibroids may also cause excessive bleeding or cramping during menstruation.

Some fibroids do not require treatment. If a woman finds her symptoms difficult to manage, doctors may recommend one of many treatments, including medications, noninvasive procedures, or surgery.

15. Tumor

In rare cases, a malignant growth in the reproductive system, urinary tract, or gastrointestinal system may be the reason for pain in the pelvis. The tumor may also cause other symptoms, depending on where it appears.

Doctors will need to perform a thorough evaluation, often using blood and imaging tests, to identify a tumor. Once they have diagnosed the issue, they will recommend possible treatments.

Dysmenorrhea (painful periods)
Dysmenorrhea can cause many women to experience discomfort during their menstrual cycle. This pain can begin a few days before the period starts and then reduces as menstrual bleeding finishes. For a small percentage of women, the pain is severe and interferes with carrying out normal everyday tasks. There are two main types of dysmenorrhea: primary dysmenorrhea and secondary dysmenorrhea. In the first, the pain occurs within healthy women and is not related to any specific problem within the uterus or other pelvic organs. However, in the latter, the menstrual pain is linked to an underlying disease or structural abnormality within or outside the uterus, such as endometriosis, fibroid tumours and ovarian cysts, or from the use of an intrauterine device for birth control.
Possible symptoms can include:

  • Pain before and during periods in the lower abdomen.
  • Cramping pain in the lower abdomen and sometimes back pain.
  • Heavy bleeds.
  • Periods may be regular or irregular.

For more information about dysmenorrhea (painful periods), its treatment and management, visit:www.pelvicpain.org.uk
Endometriosis

Endometriosis describes a condition where the lining of the uterus grows on the outside of the uterus. This can result in tissue attaching to the ovaries or fallopian tubes and sometimes to the bladder or intestines. This tissue is not shed during menstruation, unlike the lining of the uterus.
Possible symptoms can include:

  • Pain typically a few days ahead of a period and usually lasting throughout the period (where normal period pain is less severe and doesn’t usually last for the duration of the period).
  • Pain may be worse ahead of the period starting and affects the lower abdomen and pelvic area where it can be a constant ache.
  • Sex may be painful and the pain experienced deep within the body, lasting a few hours after sex.
  • There may be other symptoms such as bleeding between periods and pain on emptying the bowel or bladder.

For more information about endometriosis, its treatment and management, visit: www.endometriosis-uk.org and NICE guidance on Endometriosis.

Adenomyosis

Adenomyosis is a condition where the lining of the uterus starts to grow directly into the muscle wall of the uterus. During a period, the lining cells of the uterus bleed and the misplaced cells within the muscle wall also bleed which causes pain. Trapped in the muscle, the blood cannot escape from the cervix as it normally would. As a result, the blood and tissue accumulate and cause swelling in the uterine muscle wall.
Possible symptoms can include:

  • The accumulation of blood and tissue can cause both intense pain and cramping.
  • The condition can feel like labour pains and result in a feeling of pressure on the bladder and bowel.
  • Bleeding can be heavy when the blood is finally released from the muscle wall.
  • Loss of energy can result from associated anaemia. The cause of adenomyosis is not fully understood, but it may be a link between various hormones.

For more information about adenomyosis, its treatment and management, visit: www.pelvicpain.org.uk
Pudendal neuralgia and nerve entrapment

This condition can affect both men and women where the pudendal nerve has been damaged, trapped or irritated. It is usually a chronic condition and can be very painful and distressing. The pudendal nerve is a key nerve in the pelvis and runs through the lower buttocks, the area around the buttocks and genitals (perineum) and the area around the anus, as well the vulva, labia and clitoris in women.
Possible symptoms can include:

  • A feeling of burning, shooting pain or prickling.
  • An over-sensitivity to touch such that clothing hurts.
  • The feeling is worse when sitting and can improve when standing.
  • It tends to stay constant although sometimes it isn’t as severe.
  • Pins and needles or numbness in this area.
  • A feeling of swelling around the perineum.
  • Needing to go to the toilet more frequently.

  • Pain during arousal or sex.

For more information about pudendal neuralgia and nerve entrapment, their treatment and management, visit: www.pudendalhope.info
Fibroids

Uterine fibroids are growths that can form on the inside walls of the womb (uterus) and they are also known as myomas or leiomyomas. They are made up of muscle and fibrous tissue and can vary in size; they are non-cancerous. It is possible that a woman might be unaware of their growth because fibroids don’t always cause symptoms. One in three women may experience them, most commonly between the ages of 30 and 50 years.

Possible symptoms can include:

  • Heavy or painful periods.
  • Pain in the abdomen and pelvis.
  • Discomfort or pain in the lower back.
  • More frequent need to urinate than usual and constipation.
  • Discomfort or pain during sex.

For more information about fibroids, their treatment and management, visit: www.britishfibroidtrust.org.uk andNICE guidance on Heavy menstrual bleeding.
Cysts

There are various types of cysts that can appear under the skin or within other parts of the body. They are usually fluid-filled sacs of tissue and are usually benign (non-cancerous). Cysts often have no symptoms and can come and go without any associated problems or pain. However, if they grow large or become infected, they can become painful and unpleasant. Two kinds of cysts are associated with a woman’s reproductive organs: vaginal cyst and ovarian cyst.
Possible symptoms can include:

  • Pelvic pain – this can range from a dull, heavy sensation to a sudden, severe and sharp pain.
  • Pain during sex.
  • Difficulty emptying your bowels.
  • A frequent need to urinate.
  • Heavy periods, irregular periods or lighter periods than normal.
  • Bloating and a swollen tummy (and feeling full after eating little).

For more information about cysts, their treatment and management, visit: www.pelvicpain.org.uk
Pelvic inflammatory disease (PID)

PID is caused by an infection which can affect the pelvic organs such as the uterus, cervix and fallopian tubes. It usually involves sexual contact where bacteria enter the cervix and then spread, although it can develop as a result of childbirth, a termination of pregnancy or pelvic surgery.
Possible symptoms can include:

  • Pain in the lower abdomen and pelvic area.
  • Pain during sex.
  • Discomfort or pain when urinating.
  • Vaginal bleeding after sex.
  • Heavy and painful periods.
  • Abnormal vaginal discharge that may appear yellow or green.
  • Fever, nausea and vomiting.

For more information about pelvic inflammatory disease (PID), its treatment and management, visit: www.rcog.org.uk

Vulval pain or vulvodynia

The vulva is the external area of a woman’s sex organs or genitals. It gives protection to the sex organs and the urinary tract. It is directly between a woman’s legs and is the key site of sexual arousal and response. Vulvodynia can affect women of all ages and in otherwise healthy women. It is persistent, unexplained pain around the vulva, the skin at the entrance to the vagina. It is often a long-term (chronic problem) and can be uncomfortable and distressing. The vulva may look no different but the pain may take a number of forms.
Possible symptoms can include:

  • A burning, stinging sensation.
  • Pain provoked by touch such as during sex.
  • Pain brought on by inserting a tampon.
  • Low-level pain, but apparent all the time.
  • More pronounced pain when sitting for a while.
  • Pain may be just in the vulva.
  • Pain might be spread beyond the vulva and around the buttocks and inner thighs.
  • Sometimes, vulval pain is apparent with other conditions such as IBS, painful periods or cystitis.

For more information about vulval pain or vulvodynia, its treatment and management, visit: www.vulvalpainsociety.org or www.pelvicpain.org.uk
Pelvic organ prolapse

This is a condition where one or more pelvic organs such as the uterus, vagina, bowel and bladder, start to come down from their original positions within the pelvis and push against the vagina. This is often as a result of childbirth which can weaken the pelvic floor or damage the walls of the vagina.
Possible symptoms can include:

  • A feeling of pressure or of tissue/organs pushing against the vagina.
  • The sense that these organs are starting to descend into the vagina and which might require pushing back again.
  • A dragging feeling in or around the vagina.
  • Discomfort during sex or difficulty accessing the vagina because of bulges from descending organs.
  • A sensation of pulling or stretching in the groin or lower back which might be associated with aches or pains.
  • Difficulty passing water or leakage of urine associated with stress incontinence.
  • Problems with bowel movements or a feeling that the passage is blocked so that it is hard to have a bowel movement.

For more information about pelvic organ prolapse, its treatment and management, visit: our ‘Pelvic floor and PGP’ web page and www.rcog.org.uk
Pelvic cancer

As mentioned above, pelvic pain can be a sign of a number of different problems, but in rare instances it can indicate cancer.

Cervical cancer

A regular cervical/vaginal swab test for cancer is the best way to check for cervical health. Sometimes there are no apparent symptoms. However, it is possible to have symptoms with cancer that are similar to other conditions.
Possible symptoms can include:

  • Vaginal spotting, where blood appears between periods. Anything unusual might suggest cancer symptoms but, again, these symptoms are common to other conditions.
  • Vaginal discharge: usually some discharge is healthy but any that appears to be different – watery, thick, foul smelling or include mucus – could indicate cancer but it could also suggest other issues.
  • Painful sex and pain during urination.

For more information about cervical cancer, its treatment and management, visit: www.cancerresearchuk.org and www.macmillan.org.uk
Ovarian cancer

Ovarian cancer often develops without any obvious symptoms, and as a result it has been called the ‘silent killer’. It is not picked up through a routine vaginal swab test for cancer, but it is relatively rare.
Possible symptoms or signs can include:

  • Bloating which doesn’t seem to be linked to eating particular foods (such as gluten, lentils and pulses) but is present most, if not all, of the time. If it persists for two weeks without fading at all, it is worth checking with your GP.
  • Pelvic pain is common in all kinds of conditions, but if you experience pelvic pain like menstrual cramps or ovulation pain and the pain is not coinciding with these stages in your menstrual cycle, it is possible that this is an early sign of ovarian cancer.
  • Feeling full quickly when eating when you haven’t eaten much or you haven’t finished eating a very modest portion (and you don’t normally experience this feeling) could be an indication of ovarian cancer.
  • Frequent urination or a strong urge to urinate (although this can occur with other conditions).

For more information about ovarian cancer, its treatment and management, visit: www.cancerresearchuk.org, www.macmillan.org.uk and NICE guidance on Ovarian cancer.

Return to ‘If it’s not PGP, then what could it be?’ page.

Content added in 2017.

Hi I am 32 and past few months I been having spasms in my lower back round my bum cheeks area but recently it been happening a lot more. I am now having pains in my left bum cheek and centre of my bum cheeks and in my left side of my groin and pelvis and in my thigh. The pain is like a constant ache. Sex can be uncomfortable when I am on top as I feel like I have a cramp in lower back area around the bum cheeks. Also in my lower stomach on my left side I have like a constant straining type feeling there. Over the months i have had really bad stomach cramps and only relieves when i pass wind so i put it down to having IBS or something but now this constant ache in my pelvis and leg have got me wondering if it something more serious. I not had any blood during my periods or during sex that I have noticed but the other night I wiped my self after having a wee and there was like a pinky colour kind of discharge on the tissue. Not much just a little. I suffer with bacterial vaginosis an awful lot but put it down to different shower gels I use. I should stick to the same shower gels each time but I am terrible for different smells of shower gels and always like to try lol. These spasms I have in my lower back around my bum cheeks accurr at night and wakes me up. I am due for a smear test soon but thinking of booking in for one early. Just wondering if these are signs that there something wrong down there and if I should go to my gp straight away?. Been putting it off for a few months but the pain seems to be getting for frequent. Any advice I would appreciate it. Thank you x

Pain during intercourse is a condition that affects most women, and the discomfort can cause issues in your personal relationships. National Pain Institute offers sex pain treatments for residents of Orlando, as well as other communities in Central and South Florida.

What is Sex Pain?

Sex pain is defined as any type of discomfort that you experience on a regular basis during intercourse. The clinical term for this type of pain is “dyspareunia,” and it affects almost 75% of adult women. Many women feel uneasy about discussing sex pain, as they feel that it may indicate that their genitals or vaginal area have some type of abnormality. At National Pain Institute, we work with women who experience sex pain and provide discreet and personalized care services to help them overcome the condition.

What Are the Symptoms of Sex Pain?

The most common types of sex pain are:

  • Persistent pain in the reproductive organs.
  • Feeling as if the skin is being ripped or torn during intercourse.
  • Burning sensations.
  • Aches in the genital and vaginal region.
  • Pain in the tailbone.
  • Rectal pain.

What Are the Benefits of Treatment for Sex Pain?

Interventional pain management services for sex pain help you feel more at ease during intercourse and may help to improve your most intimate relationships. Women who suffer from this type of persistent pain often experience fatigue, depression and anxiety. These emotional issues subside after receiving treatment at National Pain Institute.

How is Sex Pain Treated?

  • Medications
  • Steroid injections
  • Nerve blocks
  • Minimally invasive spinal surgery if the origin of the pain is in the spinal nerves
  • Vitamin D testing and therapy

What Should I Expect After Treatment for Sex Pain?

After our pain management physician performs the recommended procedure, you may have an immediate reduction in sex pain symptoms or the treatment may take a few days. You do not have to limit your activities, and you can have intercourse after 24 hours. If the pain returns, please contact us to schedule an appointment for an additional treatment. We do recommend that you discuss your sex pain with your gynecologist so as to determine the underlying condition that is causing the discomfort.

At National Pain Institute, our team of pain management physicians offers sex pain treatments for residents of Orlando, as well as other communities in Central and South Florida. Contact us today to schedule a consultation.

Doctors explain why many women experience stomach pain after sex

Despite the fact that nearly one in 10 women experience pain during sexual intercourse, the topic remains taboo. Although the types of pain run the gamut, many women deal with uncomfortable cramping and stomach pain after sex.

Yvonne Bohn, an OBGYN who works with Cystex, told HelloGiggles that stomach pain usually occurs for two reasons. If a woman experiences an orgasm, it’s fabulous in the moment — but uterine contractions occur during orgasm, which can lead to stomach pain. The other reason is that, when a woman is ovulating, “deep penetration can cause pain if there’s fluid in the pelvis due to the release of the egg,” Bohn explained.

Another source of the pain can be a woman’s reaction to sperm.

“Sperm is an irritant to the uterus and the uterus will react when in contact with sperm. As such, the uterus will contract and this contraction may manifest as cramping and pain in the stomach,” Tami Prince, M.D., an OB-GYN who works as a Medical Director with U.S. HealthWorks, told HelloGiggles.

Prince explained that sperm and bacteria enter the urethra during intercourse, which can lead to irritation and pain in the stomach and pelvic regions.

“I recommend showering immediately after intercourse in order to wash away remnants of sperm, as well as urinating immediately afterwards in order to rid the urethra from sperm and bacteria introduced during sex,” Prince said. She also suggested putting a warm compress on your stomach.

Typically the pain and cramping will go away on their own. But if the pain is severe and persistent, it’s important to schedule an appointment with your OB-GYN. Sex is meant to be pleasurable for both partners, and it’s hard to enjoy the pleasure of intercourse when you’re anticipating severe pain in the aftermath.

  • By Caitlin Flynn

If you’ve been suffering with painful orgasms (otherwise known as dysorgasmia), you are not alone. In fact, the problem may be more widespread than you think. The Sexual Advice Association reports that problems with orgasm are fairly common, likely affecting more than 20 per cent of women. And while these problems are not limited to pain (other problems include never having an orgasm, infrequent orgasms and reduced sensations), it’s clear the issue needs some investigation.

And yet if you perform an online search, it quickly becomes apparent that, while there has been research into male dysorgasmia, there is very little (if any) scientific explanation into the causes of female dysorgasmia.

What is dysorgasmia?

Pain in the abdomen or pelvic area during or immediately after you reach orgasm is officially known as dysorgasmia.

‘Interestingly, most peer-reviewed articles relating to dysorgasmia appear to be studying the phenomenon in males after radical prostatectomy – surgical removal of the prostate gland, usually for prostate cancer,’ acknowledges Professor Mark Whiteley, consultant venous surgeon at The Whiteley Clinic.

If you are experiencing dysorgasmia, it’s important to seek help, because pain is not a normal part of sex – or climaxing.

‘In females, dysorgasmia has only been reported in scientific journals following removal of the rectum and colon as a child with reconstruction of the bowel (proctocolectomy), in women with long-term Type I diabetes (insulin-dependent diabetes) and in one woman following removal of an embryological cyst intimately lying between her bladder and belly button (urachal cyst),’ adds Professor Whiteley.

But let’s be clear here: lack of scientific study into the problem does not make it any less real, and if you are experiencing dysorgasmia, it’s important to seek help, because pain is not a normal part of sex – or climaxing.

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What does dysorgasmia feel like?

Dysorgasmia symptoms can vary, but it often feels like cramping.

‘Dysorgasmia is the feeling of pain in your abdomen or pelvic area right after an orgasm, or sometimes during,’ explains Eleni Mavrides, consultant obstetrician and gynaecologist at the Portland Hospital, part of HCA Healthcare. ‘It’s believed to be uncommon, although it’s not known how many women experience dysorgasmia. It’s thought it may be caused by a variety of underlying issues, including disorders of the uterus or bladder, or use of medications such as antidepressants.

‘Usually the pain feels like intense cramps, which is the result of your vagina and muscles in your pelvis contracting. It’s difficult to say how long the pain can last, as this completely varies from person to person.’

Related Story

What causes dysorgasmia?

Because there has been no conclusive research into the causes of dysorgasmia, it’s difficult for experts to say definitively what causes it. However, there are several theories as to the pain’s origin. Mavrides outlines the following possible causes:

• Uterine or bladder disorders and dysorgasmia

It’s possible that an underlying uterine or bladder disorder may lead to dysorgasmia, although research in this area is minimal. For example, uterine fibroids – benign tumours that show up on your uterus – are one of the most common reasons people can have intense cramps after sex.

• Ovarian cysts and dysorgasmia

Another common reason for dysorgasmia is ovarian cysts, which are small sacs filled with fluid. Ovarian cysts are very common in women and, in most cases, they will go unnoticed and go away on their own. If your post-orgasm cramps are localised to one side, it may be the result of a cyst.

• Endometriosis and dysorgasmia

Endometriosis, which can also cause pelvic pain just before, after or during menstruation, can also lead to dysorgasmia. Endometriosis is a condition where the lining of the womb starts to grow in other places, which leads to irritated tissue developing into painful scar tissue or adhesions. The latter is what causes the pain after an orgasm.

• Pelvic inflammatory disease and dysorgasmia

Pelvic inflammatory disease (PID) is another potential underlying factor that can lead to dysorgasmia. The inflammation of your pelvic area can cause pain during and after an orgasm.

However, as Professor Whiteley states, with a lack of conclusive evidence, it’s hard to know for certain what causes dysorgasmia in women.

‘Although popular press reports suggest that endometriosis, ovarian cysts, “touching the cervix”, fibroids and other pelvic-related structures or practices might be a cause of dysorgasmia, it is very difficult to find any peer-reviewed published literature to support these,’ says Professor Whiteley. ‘And as it is known that many women have these conditions and do not get dysorgasmia, it may well be that the two things can coexist in certain patients, without being a causative relationship.’

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Dysorgasmia and the nervous system

Professor Whiteley puts forward an alternative suggestion for the cause of dysorgasmia, relating to the nervous system.

When looking for the cause of painful orgasms, it’s important to also consider the mental and emotional factors.

‘Going back to basics, sexual function is largely governed by the autonomic (non-voluntary) nervous system,’ he says. ‘This is split into two parts. The parasympathetic system tends to give effects that can be thought of as “restful”, whereas the sympathetic system tends to give results related to action and is often quoted as being part of the “fight or flight” response. The sympathetic nervous system is also enhanced by the release of adrenaline.’

‘It is generally accepted that sexual arousal is due to parasympathetic nervous activity, whereas orgasm is due to sympathetic nervous activity,’ he adds. ‘As dysorgasmia is pain during the orgasm, it could be that dysorgasmia is related to an abnormal response to sympathetic stimulation or overstimulation, which may include an enhanced response to adrenaline.’

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Dysorgasmia and mental health

When looking for the cause of painful orgasms, it’s important to also consider the mental and emotional factors that could be at play – which is absolutely not dismissing it as being “just in your head”. In fact, past trauma, such as assault, or any fears surrounding sex and intimacy, can play out as real, physical pain, and this should never be dismissed.

‘When treating someone for pelvic pain and dysorgasmia, it’s always important to consider their health from a psychological and emotional perspective, rather than only physically,’ agrees Mavrides. ‘Experiencing mental health issues can be linked with physical pain, so it’s worth discussing any difficulties you’re experiencing more generally when seeing your doctor about dysorgasmia.’

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Dysorgasmis treatment options

Successful treatment for painful orgasms relies first upon discovering the particular underlying cause that is playing out for you. If your doctor is able to determine this, then appropriate action can be taken.

Successful treatment for painful orgasms relies first upon discovering the particular underlying cause.

‘Experiencing mild dysorgasmia once, without other symptoms, is not necessarily a cause for concern,’ says Mavrides. ‘However, if you’re experiencing dysorgasmia alongside painful periods, pelvic pain at other times during your cycle, a burning or itching sensation in your genitals or any abnormal changes to your discharge, it’s important to consultant your doctor.’

Mavrides also says that simple over-the-counter medication can be taken to help ease pain in the short term. ‘Dysorgasmia can generally be soothed the same way period cramps are, with heat from a hot water bottle or over-the-counter painkillers and non-steroidal anti-inflammatories, such as paracetamol or ibuprofen.’

But one thing is certain – if you’re experiencing painful orgasms, it’s important to seek help. ‘It is not normal to feel pain either during or after sex,’ states Mavrides. ‘Sex and orgasm should be an enjoyable experience for both men and women, and it’s therefore incredibly important to address the problem.’

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Last updated: 18-09-19

Dr Juliet McGrattan (MBChB) Dr Juliet McGrattan Dr Juliet McGrattan spent 16 years as a GP, two years as a Clinical Champion for Physical Activity for Public Health England and is the Women’s Health Lead for the 261 Fearless global running network. Her award winning book, Sorted: The Active Woman’s Guide to Health was published by Bloomsbury in 2017.

AS women we’re no stranger to cramps, but they usually only rear their ugly head when it’s your time of the month.

So it’s understandable you’d be annoyed or confused if they were happening after sex.

9 It’s not unusual for a woman to experience cramps after sex, but if you’re worried you should see a GPCredit: Getty – Contributor

Not to worry though, it doesn’t necessarily mean anything bad.

For some women cramps after sex after just a normal part of life, which can put a real downer on the pleasure that comes before them.

It may be caused by an adverse reaction to your partner’s sperm, or it could be a sign of an underlying medical condition.

Here’s what may cause cramping after sex.

1. His sperm

9 Your partner’s sperm contains a hormone called prostagladins, which can contribute to inflammation and crampingCredit: Getty – Contributor

Semen contains a hormonal called prostaglandin, which some women have an adverse reaction to.

Prostaglandins are found in almost every tissue in the body and play a role in processes like inflammation, blood flow and the formation of blood clots.

It also plays a major role in the induction of labour, which can cause some serious uterine cramps!

So that’s why some women react with cramps to their partner’s sperm.

2. Uterine fibroids

9 Uterine fibroids are non-cancerous growth that can occur anywhere in the uterus and can cause crampingCredit: Getty – Contributor

A fibroid is a non-cancerous growth that can occur anywhere in the uterus.

Symptoms vary depending on their size – the bigger they are the worse the symptoms can be.

Most women experience irregular bleeding, heavy periods, pain and cramps in the pelvis – and those cramps can strike after sex.

In some cases, if they are left untreated, they can cause infertility so if you have any symptoms speak to a GP.

3. Your period

9 Some women experience cramps in the lead up and during their period, which can be made worse by sexCredit: Getty – Contributor

It seems like an obvious point, but cramping could be a sign your period is about to start.

Period pain occurs when the muscles in the womb tighten, ready for the lining to shed each month.

FIND OUT MORE The 8 reasons you might suffer cramps AFTER your period – and when to see your doctor

In the lead up to your period these cramps tend to start lightly, becoming more intense during your period.

While your body is going through this process it also produces prostaglandins, as mentioned above, which can make the cramps more intense.

Some women find they might cramp more when they have sex during their period because of these hormones, and the uterus is already working hard to get rid of the menstrual blood.

Other women find sex eases their cramps because of the feel-good hormones that are released.

Check where you are in your cycle if you start to experience cramping after getting down and dirty.

4. You’re ovulating

9 When an egg is released ready for pregnancy it can cause cramping. If you have sex during this time you might experience cramping during and afterCredit: Getty – Contributor

Ovulation cramps are a real thing.

Some women might not notice them, but others can pinpoint the days they are ovulating.

Put simply, ovulation is when your body releases an egg during your menstrual cycle in preparation for getting pregnant.

Part of the ovary called a follicle releases the egg which travels down the fallopian tube and hopes to be met by sperm.

TIME OF THE MONTH The 4 signs you’re at your most fertile point each month – including ovulation cramps

Just like when you have your period, you might experience cramps when you are ovulating.

Some women describe them as pelvic cramps, others may experience lower back pain.

If you are someone that suffers really bad period pain – think pain shooting down your upper legs – you may experience stronger ovulation cramps than others.

The exact cause of ovulation cramps isn’t known, but several theories suggest it may be caused when the follicle stretches before releasing the egg or when the follicle ruptures when releasing the egg.

Fluid released by the follicle when it ruptures may also irritate the lining of your abdomen causing pain.

Again, it’s a good idea to check where you are in your cycle if you have cramps after sex.

5. Your orgasm

9 When you have an orgasm it causes contractions in the uterus, which may result in cramps for some womenCredit: Getty – Contributor

What? Isn’t that supposed to be pleasurable?

In short, yes, your orgasm will take you to heady heights.

But afterwards some women are brought back down to reality with cramps.

Here’s something you might not have know – orgasms not only trigger contractions of the vaginal wall, it can lead all the way up into the uterus.

These contractions, while pleasurable at the time, can cause tension in the uterine muscles and therefore cause cramps.

6. Endometriosis

9 Endometriosis causes tissue that behaves like the lining of the womb to grow outside the womb and can cause pain and cramping all the timeCredit: Getty – Contributor

Endometriosis is a chronic condition which occurs when tissue which behaves like the lining of the womb is found outside of the womb – in areas of the body including the ovaries, Fallopian tubes, the abdomen and the bladder.

Symptoms of endometriosis can vary, but the most common include painful or heavy periods, pain during and following sex, bleeding between periods, pain in the lower abdomen and difficulty conceiving.

It can cause cramping all month long, including during and after sex.

Endometriosis can sometimes cause damage to the Fallopian tubes or ovaries, leading to fertility problems.

Other complications can include painful ovarian cysts and adhesions – areas of tissue which can fuse organs together.

Speak to your doctor about ways to manage the condition.

7. Your contraception

9 If you’ve just had an IUD fitted you may experience some cramping for a few weeks, but it should go away on its ownCredit: Getty – Contributor

If you’re using an IUD then it’s not uncommon to experience cramping after sex.

This is a small plastic and copper device that is fitted in a woman’s womb, and can last for between five and 10 years.

The coil, or intrauterine device, is more than 99 per cent effective against unwanted pregnancies, but can cause heavier or painful periods in some women.

When you first have one inserted you may experience cramping for several weeks, regardless of whether it’s your time of the month or not, while the uterus gets used to having it there.

These cramps may be more intense after sex, but eventually they go away.

But if it lasts longer than a few weeks you should speak to your doctor to be on the safe side.

8. Cysts

9 A burst ovarian cyst can also cause cramping, as well as bloating and painful periods. If you have these symptoms you should speak to a GPCredit: Getty – Contributor

It’s unlikely that you have a ruptured ovarian cyst, but it’s still a good idea to be aware of the symptoms in case you have one.

An ovarian cyst is a fluid-filled sac that develops on a woman’s ovary.

Most ovarian cysts occur naturally and disappear in a few months without needing any treatment.

Ovarian cysts may affect both ovaries at the same time, or they may only affect one.

An ovarian cyst usually only causes symptoms if it ruptures, is very large, or blocks the blood supply to the ovaries.

Then you may experience pelvic pain, pain during and after sex, difficulty doing a poo, a frequent need to week and heavy or irregular periods.

You may also have some bloating and a lack of appetite.

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9. Pregnancy

It’s perfectly safe to have sex when you’re pregnant, right up until your water breaks.

Pregnant women often experience cramping after sex, for the same reason an orgasm can cause pain.

Orgasms set off contractions in the womb, which can lead to cramps.

They are particularly common for women in their third trimester because their body is already preparing for labour.

Relaxing for a few minutes can ease the cramps but always see a doctor if you are worried about anything during your pregnancy.

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