Many women experience pain or cramps after sex. Usually, it is a result of orgasm or muscle tension. But, it may also be a sign of a medical problem like endometriosis or uterine fibroids.
Pain after sex can also be a symptom of pelvic inflammatory disease (PID). It is usually accompanied by a foul-smelling vaginal discharge or fever.
1. You Have an Ovarian Cyst
Ovarian cysts are fluid-filled sacs that develop on or inside an ovary. They are fairly common and usually go away on their own without treatment. However, they can be dangerous if the follicle becomes torsioned (twisted) or ruptures. In some cases, doctors will drain or remove a cyst with laparoscopy, which is done using a thin lighted telescope and small instruments inserted through an incision in the abdomen.
Each month, one of the ovaries grows a follicle that contains an egg. The follicle typically ruptures and releases the egg about 2 weeks before you get your period. However, sometimes a follicle can keep growing, even after the egg has been released. This growth causes a functional cyst called a follicular cyst or corpus luteum cyst. Another type of ovarian cyst is the dermoid cyst, which contains tissue such as hair or teeth.
If the ovary becomes too large, it can lead to problems with your menstrual cycle, including heavy periods and spotting between periods. Large cysts may also cause pain in the lower abdomen, especially on the side with the ovary.
Having a tilted uterus can increase the chances of having painful sex after sex because the pelvic floor muscles involuntarily tighten when something enters the vagina, such as a medical exam or penetrative sex. Having the condition can also make it harder to insert a tampon.
2. You Have a Tilted Uterus
Women with a tilted or retroverted (backward) uterus can experience pelvic pain during sexual intercourse. This is because the uterus can hit the penis during sexual penetration when the woman assumes the woman-on-top position. This is a condition known as collison dyspareunia.
A uterus can be tilted due to pregnancy, fibroids or scarring in the pelvis (endometriosis, infections or surgery). In addition, a uterus may be tipped because of a birth defect or abnormal growth in the uterus called a polyp.
In many cases, a uterus that’s tilted is not a cause for concern. For example, it’s normal for the uterus to shift to a retroverted position during the first trimester of pregnancy, and it will usually correct itself after pregnancy. A tipped uterus can also be caused by fibroid tumors or a cyst in the ovary.
In these cases, a tipped uterus usually doesn’t cause any problems with fertility or pregnancy, though it may make it difficult to use tampons. However, in some cases, a tipped uterus can cause a urinary tract infection because urine can collect in one place rather than being flushed away through the fallopian tubes. A gynecologist can prescribe pelvic exercises or a pessary to help the uterus move back to its normal anteverted position. A doctor can also perform a laparoscopic procedure to remove the scar tissue, adhesions or tumor that’s causing the uterus to tilt.
3. You Have Vaginismus
Vaginismus is a recurrent involuntary contraction of the muscles that creates a tight and narrow vagina. This condition can make sexual activity, pelvic exams and even inserting tampons painful. It can also interfere with your intimate relationships and lead to depression and anxiety. It can also cause pain in other areas of the body.
It is more common in peri- and postmenopausal women, but anyone can get it at any age. Symptoms include pain during sex, difficulty inserting tampons and vaginal discharge. It can be caused by a lack of estrogen (menopause), an infection, urinary tract problems, uterine fibroids or fibroid tumors and other conditions that affect the female reproductive system.
Another common cause of pain during sex is pelvic inflammatory disease (PID), which occurs when bacteria in the vagina spread to the uterus, fallopian tubes and/or ovaries. Symptoms of PID include a dull pain in the lower abdomen and pelvis, painful or itchy vaginal discharge, abnormal vaginal bleeding and pelvic pain during sex.
If you have vaginismus or any other pelvic floor issues, it’s important to seek medical attention. A pelvic floor physical therapist can help determine whether or not your symptoms are due to vaginismus and provide you with an evidence-based treatment plan. You can book an appointment with an Origin physical therapist here or see your primary care provider to start.
4. You Have an Infection
While discussions of sex usually revolve around pleasure, pain during or after coitus can be a sign that something’s wrong. This could be due to a number of things including a cyst, vaginismus, or infection.
For women, the most common cause of painful sex is endometriosis. This is a condition that occurs when tissue similar to the lining of the uterus grows in other places like the pelvis, abdomen and ovaries. If these cells get irritated during penetration it can cause pain and even lead to infertility, explains McGuirk.
Men can also experience pain during sex if they have a condition known as a fibroid. These are benign growths that often cause no symptoms but can get irritated during penetration and might be responsible for pain after sex.
Sexually transmitted infections, particularly chlamydia and gonorrhea can cause abdominal cramps that might be experienced during or after sex. Most STIs are asymptomatic but they can still cause a lot of pain, so it’s important to be tested regularly.
Infections can be very dangerous if they’re not treated quickly, so if you’re experiencing pain after sex see your doctor. They may be able to provide you with medication or refer you to a specialist. They can also advise you on how to prevent future pain and discomfort. So remember that moaning after orgasm isn’t just about pleasure—it’s a sign that your body needs attention.
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