Usually pain after sex is a normal part of an orgasm, but sometimes it can be an indicator that you might have an STI like chlamydia or gonorrhea. These STIs can lead to pelvic inflammation disease, which causes uterine cramping and pain.
In endometriosis, the tissue that lines the uterus grows outside of it, creating dense adhesions in the pelvic area. This can cause deep penetration pain and even make penetrative sex painful.
A common cause of pain during and after sex is endometriosis, which strikes about 1 in 10 women of childbearing age. It happens when the cells that line your uterus start growing in other areas of your body, such as on your fallopian tubes or pelvic wall. Some experts believe these misplaced cells are triggered by a process called retrograde menstruation, which occurs when your period’s blood moves back through your fallopian tube into the vagina, instead of out of it. Other theories suggest that hormones turn cells in your abdomen into ones that resemble the tissue of the uterus.
When these cells touch your lower abdomen and pelvic area, they cause irritation that causes pain. The resulting cysts can be painful, and they may even rupture on their own, making you feel worse. In addition, these cysts can make it hard to get pregnant.
If your pain is severe, you should see a doctor for evaluation, explains Yale New Haven Hospital ob-gyn Mary Jane Minkin. She says it’s important to rule out a possible ectopic pregnancy (when a fertilized egg implants outside the uterus), and an ultrasound can help. If you have endometriosis, your doctor will discuss surgical options to reduce your symptoms. Until then, you can try over-the-counter pain relievers and avoid sexual activity until the pain goes away.
During sex, your body stretches and contracts muscles throughout the pelvic region. For some people, this can cause injury to the ligaments that attach your uterus and bladder (called the pelvic floor). If you have scar tissue connecting organs that shouldn’t be connected, those organs can get pushed or pulled during penetration, which causes pain. If you have a tilted uterus (around 30 percent of women do), it can also affect the sensation during intercourse.
If you’re using an intrauterine device (IUD) to prevent pregnancy, it can sometimes contribute to cramping during sex. These tiny pieces of plastic inserted into the uterus block sperm from reaching an egg and, in some cases, release hormones to prevent conception.
Another potential cause of sex-related pain is an infection. A urinary tract infection (UTI), bacterial vaginosis, or yeast infections can all cause cramping in the lower abdomen and pelvic area. During sex, bacteria from the genital and anal tracts can make their way down the urethra and infect your bladder. This can lead to a burning, painful feeling during and after sex.
If you’ve been sexually assaulted or are a survivor of domestic violence, the trauma you experienced can cause emotional and physical pain after sex. If you experience this, talk to a medical professional to understand what’s going on and how to address the pain.
One of the most common causes of uterus pain after sex is cramping. This is usually a result of deep penetration during sex that bumps the cervix and uterus, causing muscles to tighten. Over-the-counter pain relievers should help. If the pain is recurrent, you may want to talk with your doctor.
Another possibility is a pelvic infection, or pelvic inflammatory disease (PID). If an STI like chlamydia, gonorrhea, or mycoplasma genitalium travels to the uterus, fallopian tubes, or ovaries, it can cause PID, and you’ll experience pain during and after sexual activity along with painful menstruation.
Fibroids, or noncancerous uterine tumors, can also lead to post-sex pain. You might experience the pain in the vagina or lower back, where a fibroid is pressing on your organs. You can often tell if you have a fibroid if you have regular, heavy periods with severe cramping.
Ovulation cysts, fluid-filled sacs that form on the ovaries, can also cause pain during and after sex. These cysts typically go away on their own, but if they rupture during sex or while trying to insert a tampon, it can be quite painful. Vaginal dryness, exacerbated by hormone changes or medication side effects, can be another cause of painful sex. Using a quality lubricant and moderating the depth of penetration during sex can prevent this.
The good news is that, if you have pain in your stomach after sex, there isn’t anything to be alarmed about. However, it could still be an indication of a medical issue that you need to talk about with your doctor.
If you have a popped cyst, for instance, the fluid that is released can cause pain in the pelvic area if it isn’t reabsorbed right away. Additionally, “if scar tissue connects organs that shouldn’t be connected, such as the intestines to the uterus, then during intercourse they can get pushed or pulled,” says Gelman. This is known as endometriosis of the pelvis or abdominal adhesions, and it can be painful during or after sex.
Also, if you have fibroids (non-cancerous uterine tumors), those can sometimes trigger pain during sex. They may even make menstrual cramps feel like stabs.
Also, if you have a vaginal infection or a sexually transmitted disease, such as chlamydia or gonorrhea, it can travel from your vagina to the uterus, fallopian tubes, and ovaries. This can cause vaginal and pelvic pain, and sex aggravates this type of pain because it rubs an already inflamed area.