The uterus can cramp during orgasm, and it’s usually harmless. But when the pain is more severe and lingers for hours or days, it could signal something serious.
Pelvic pain after sex can be caused by STIs, including chlamydia and gonorrhea. It can also be a symptom of pelvic inflammatory disease.
Semen
The body makes semen — also known as ejaculate, spunk and many other less-than-flattering nicknames — to help the sperm swim their way from the penis to the fallopian tubes. The prostate contributes 15-30% of the fluid by adding enzymes, citric acid, sugar, calcium and zinc. The seminal vesicles supply the bulk of the fluid, containing 50-65% sperm, as well as proteins, ascorbic acid, sugar, amino acids, phosphorus and l-carnitine. The vesicles also provide the fluid with biological markers, including trace amounts of the hormone prolactin and prostaglandins.
If the uterus is irritated by contact with the sperm, it can react and cause pain. Women can also experience pain from sex positions that put pressure on the cervix, like missionary or doggy style. Experimenting with different sex positions can help ease the pain. It is important to wash down anal or vaginal areas with urination after sexual intercourse to flush out any bacteria that could cause irritation. If the pain persists, talk to a gynaecologist about other causes of pelvic cramping. This could include infections like pelvic inflammatory disease, a retroverted uterus or endometriosis.
Cysts
A little cramping during or after sex is totally normal as the muscles contract during an orgasm. But it’s not so great if that cramping is prolonged or happens regularly, which may indicate there’s a medical cause for it.
For example, an ovarian cyst — fluid-filled sacs that form on one of the ovaries — can cause pain during sex because it’s in the same area as the uterus, Minkin says. Also, if you have a retroverted uterus, which means your uterus sits tilted against the pelvic bones, deep penetration can be uncomfortable.
Fibroids, which are muscular tumors that occur in the wall of the uterus, can also be painful during or after sex. They’re usually harmless but can lead to heavy menstrual bleeding and abdominal pain, including after sex, if they grow near the cervix. Also, bladder and bowel issues like constipation or interstitial cystitis can hurt during sex because they are all connected by nerves in the pelvic area, Lincoln adds. And scar tissue from past surgeries in that area can be irritated during sex, as well.
Your Period
There are a few reasons that your period might cause cramping during or after sexual activity. One is a reaction to sperm, which can trigger pain when it’s touched during penetration. Another reason is pelvic inflammatory disease, which can cause pain in the uterus and the pelvic area. This can be caused by bacteria (known as vaginal infections), or STIs such as chlamydia and gonorrhea.
The pain that you might feel during orgasm can be a result of the contractions and involuntary pelvic floor muscle movements that occur during sexual activity. Sometimes these muscle contractions will continue after sex is over, and that’s when you might experience post-orgasm cramps.
If you’re pregnant, then you may also experience pelvic pain after sex as your uterus grows and puts pressure on the bones, muscles, and ligaments of the pelvic area. Your doctor can give you advice on what to do if you are pregnant and having pain after sexual activity. They might recommend a pelvic exam or sex with less force. If the pain is severe, then you might need to take an anti-inflammatory medication.
Endometriosis
Endometriosis is a condition in which tissue from the uterus (the organ where sperm and egg meet to create a baby) grows outside of the womb and clings like a leech to other organs. It causes inflammation, scarring and adhesions that can lead to pelvic pain, painful menstrual periods, infertility, and bowel or bladder problems.
One of the main symptoms is pelvic pain during and after sex. It’s usually worse with penetration, and can be felt as pain that feels like your uterus is being pulled or tugged. It can also cause cramping in your abdomen or lower back.
Your doctor can diagnose endometriosis by doing a pelvic exam and using imaging tests, such as an ultrasound or CT scan. They can also perform a laparoscopy, in which they make a small cut in your belly and insert a thin tube with a camera on the end (called a laparoscope) to see what’s going on inside your pelvic area. They may then take a sample of the tissue and look at it under a microscope to be sure.
Infections
A woman may have cramping after sex when she has pelvic inflammatory disease (PID). This happens when sexually transmitted bacteria spread from the vagina and cervix to her fallopian tubes, uterus, and ovaries.
STIs such as chlamydia and gonorrhea can cause PID. This infection causes pain and an unsatisfactory vaginal odor. If you have these symptoms, see your doctor right away.
Women can also have PID when their uterus has fibroids, which are noncancerous growths in the muscular wall of the uterus. These can be very tiny or as large as a cantaloupe. These growths can cause sex cramping or menstrual cramps.
A uterine infection is rare, but it’s important to tell your health care provider if you have severe or constant cramping after sex. It could be a sign of an infection, such as endometriosis or a urinary tract infection (UTI).
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