The uterus and other pelvic muscles contract during orgasm. This may cause cramping. Using a sexual lubricant can lessen the discomfort and pain.
It could also be caused by deep penetration that pushes against the cervix. Or it could be a symptom of pelvic inflammatory disease (PID), caused by STIs like chlamydia and gonorrhea.
Endometriosis
Women who have endometriosis experience pain during intercourse, particularly during deep penetrative sex. This happens because the movement of a penis or sex toy can irritate sensitive tissues and restricted muscles that are already aggravated by endometrial tissue growing outside the uterus. It can feel like sudden, stabbing or jabbing pain ranging from mild to severe. The pain can last for hours or days after sex. It tends to be worse around ovulation or prior to a period.
Some women with endometriosis also suffer from dyspareunia, which is pain that extends down the sex tube. This pain can be felt in any sexual position, but is usually worse with deep penetration.
Dyspareunia can lead to a loss of pleasure and couples may stop having sex altogether. It’s important to talk about your sex life with your doctor, and while it can be hard to bring up, it’s worth the effort to get the treatment you need.
Pelvic Inflammatory Disease
Pelvic inflammatory disease, or PID, is when part of your reproductive system—like your uterus, Fallopian tubes and ovaries—gets infected. It’s usually caused by bacteria from a sexually transmitted infection, like chlamydia or gonorrhea, but normal bacteria in your vagina can also cause it. Getting it treated early and properly can help you avoid long-lasting pain, and keep it from causing pregnancy complications down the road.
A number of other medical conditions can cause pain during sex, including uterine fibroids and a tilted uterus. If you’re not sure what’s causing your pelvic pain, your doctor will be able to run some tests and find the right treatment for you. Until then, try switching up your sex routine or using extra sexual lubricant. If it doesn’t help, talk to your doctor about other ways to get relief—like changing positions or undergoing surgical treatment for pelvic pain.
Tilted Uterus
In normal anatomical position, your uterus (the organ where a baby grows during pregnancy) sits in your pelvis between your bladder and rectum. It’s shaped like an upside-down pear and typically tips forward at the cervix. Having a uterus that’s tipped backward, or retroverted, isn’t unusual and it doesn’t usually affect your chances of getting pregnant or your health.
However, the uterus can get tipped from scar tissue created by abdominal or pelvic surgery, as well as a condition called endometriosis or fibroids. It can also become tipped by pregnancy, menopause or the stress of rough, deep penetration sex, which can cause the ligaments that hold your uterus in place to stretch. As a result, it can be more likely to tip backward during intercourse and make contact with the penis head or one of your ovaries, which causes pain. Also known as coccydynia, it’s sometimes treated with pelvic exercises and sometimes surgically corrected.
Semen
When men have sex, semen is released along with sperm. Semen is a thick fluid that’s a combination of mature sperm and liquid from different male sex organs including the testicles, epididymis, vas deferens, seminal vesicles, prostate gland and bulbourethral glands. It also contains sugars, proteins, citric acid and enzymes.
Semen carries sperm (tadpole-shaped, microscopic cells that fertilize the egg to promote conception) to the female reproductive tract. The sperm needs this cocktail to get there because the female body actively works to reject sperm. The fluid from the seminal vesicles adds sugar, ascorbic acid, amino acids, and other nutrients, as well as prostaglandins that help the sperm sneak into the uterus undetected.
Sometimes, pain during sex is a result of having a low estrogen level or due to certain sexual positions or activities. This can be helped by using a lubricant, having more foreplay and finding sex positions that don’t cause pain.
Cysts
If you have cysts on your ovaries, fluid-filled sacs that develop on the ovary, they can cause pain during or after sex. Women who have a cyst may experience pelvic and lower abdomen pain that gets worse during sexual activity or in certain positions. Often, this pain is temporary and goes away with lubrication, a change in sexual positions or medication. Women with a cyst may also have heavy periods.
Another common cause of painful intercourse is uterine fibroids, which are muscle tumors that can grow in or on the uterus. These tumors are usually benign, but can cause severe pelvic and abdominal pain during sex.
A little cramping after sex is nothing to worry about, but persistent or severe pain warrants a visit to your gynecologist. Your doctor will ask you about your history with sex and pelvic pain, and do an ultrasound or laparoscopy to see what’s going on.
Your Period
If you’re a woman, every month during ovulation your body makes an ovarian cyst and releases an egg. Occasionally, those fluid-filled sacs cause pain during sex. You may experience this as pain that persists after orgasm, or it could be more serious (collision dyspareunia). You can reduce the risk of these types of uterine contractions by using sexual lubricants, becoming more relaxed and increasing foreplay.
Cramping and pain during or after sex can also be a sign of a UTI, if you have one. In that case, a doctor will prescribe antibiotics to help clear up the infection. And, as always, if pain or cramping is severe, talk to your healthcare provider. They will be able to assess your symptoms and determine whether you need to see a specialist. Cramps during or after sex are normal, so don’t be embarrassed to ask for help.
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