It’s not uncommon for some people to feel stomach pain after orgasm. It may be due to the uterine muscular contractions that naturally occur during orgasm.
In some cases, this can lead to a painful condition called dyspareunia. The location and intensity of the pain is important for diagnosing the underlying cause.
Endometriosis
Whether it happens during or after sex, stomach pain is never fun. Known as dyspareunia, it can feel sharp, cramp-like or burning, and might be felt superficially around the vagina entrance, or deeply inside the belly. The pain can also spread to the pelvic area, lower back or thighs. But if it continues after the orgasm, it might be something more serious than just a bad sexual position.
One possible cause of the pain is endometriosis, a condition where cells similar to those in the womb grow outside of the uterus. During the menstrual cycle each month, hormones help this lining of the womb to grow in preparation for a fertilized egg. However, when the lining doesn’t become fertilized, it breaks down and bleeds each time — but the blood can’t leave the body and instead is reabsorbed by the body tissues, causing inflammation, pain and scar tissue.
Over time, these cell layers can form cysts and adhesions, which can cause long-term (chronic) pain, including during periods. Women with endometriosis often have trouble getting pregnant, and surgery to remove the scar tissue can sometimes help.
Other medical issues that can lead to stomach pain after sex include pelvic inflammatory disease, ovarian or pelvic cysts, pelvic fibroids and sexually transmitted infections like chlamydia. Some of these problems can be helped with birth control pills, increased estrogen in post-menopausal women and dietary changes. Other treatments can involve a gynecologist or urologist, and a physiotherapist or pelvic floor specialist to help with bladder or bowel problems.
Pelvic Inflammatory Disease
A vaginal infection from bacteria normally found in your vagina or from a sexually transmitted disease, such as chlamydia and gonorrhea can spread to your uterus, fallopian tubes, or ovaries (also known as pelvic inflammatory disease). This usually causes pain or cramps, and can also cause spotting or irregular periods. In some cases, it can also prevent pregnancy and lead to a tubal or ectopic pregnancy. This condition mainly affects women and people AFAB who are 15-25 years old.
Having sex can make the pain worse, as it can cause uterine muscle contractions that can make your abdomen painful or uncomfortable. The pain may also be caused by certain sexual positions, like deep penetration, that puts pressure on your uterus.
If you experience sharp pain after sex, your doctor will take a detailed history to see if there are any patterns or triggers that can help them identify the cause of your symptoms. Often, they will recommend that you have a swab taken of your vagina or cervix to check for the presence of chlamydia or gonorrhea as well as a pelvic ultrasound or CT scan to find out what is causing your symptoms. Treatment can include medications and antibiotics. It can also include surgery to remove tissue, drain pus, or treat any damage done to the uterus and tubes.
Uterine Fibroids
Uterine fibroids are clumps of tissue that form inside the uterus (womb). They can cause pain during menstruation and after sex. Fibroids can also lead to pelvic pain, back pain, bloating and abnormal bleeding. They are more common in women of reproductive age and in those who have a family history of the condition. They can also be caused by being overweight, having an early start to menstruation and by certain medications like clomid or progesterone.
If you have uterine fibroids, your doctor will ask about your medical history and examine you. They will also run tests to find out how large the fibroids are and where they are. This includes an ultrasound and blood tests. The tests can help your doctor decide what treatment option is best for you.
If you have uterine fibroids, one possible treatment is a procedure called the uterine fibroids embolization (UFE). This involves inserting a tube through your vagina into the fibroid to cut off its blood supply. It is a minimally invasive procedure that has an 85 to 95 percent success rate. The fibroid will then die and break up on its own. The procedure is quick, has few side effects and doesn’t affect your ovaries or fallopian tubes. Other treatments include taking medicines to shrink the fibroid or having surgery.
Pelvic Infections
Sometimes bacteria from your vagina spreads to the uterus, fallopian tubes, or ovaries (pelvic inflammatory disease or PID), causing pain that feels like stomach pain. The pain may be constant, and it can also come and go. If untreated, this can cause damage that makes it harder to get pregnant. This kind of sex infection is very common, and it can occur for many reasons, including STIs like chlamydia and gonorrhea, but it can also happen for no obvious reason.
Another possible cause of pelvic pain after sex is ovarian cysts, fluid-filled sacs that develop in or on an ovary. These are typically harmless, but they can be painful if they cause the ovaries to become inflamed or irritated, says Kameelah Phillips, MD, an OB/GYN in New York City.
Pelvic and abdominal cramping during orgasms might contribute to stomach pain after sex for some sexually active people, Whelihan explains. This pain can be more intense if you’re going through different stages of your menstrual cycle, or it could result from hormonal shifts caused by birth control pills and other medications.
Lower abdominal pain during sex, known as dyspareunia, is pretty common and rarely causes a serious problem. But if the pain is severe or happens regularly, it’s a good idea to visit your health care provider so they can determine what’s causing it.
