Cramps and pain during sex are not uncommon, but they’re also not necessarily a sign of something serious. Typically, these cramps are due to muscle strain from awkward positioning or involuntary pelvic floor contractions during an orgasm.
However, if you experience frequent or recurring pain in this area, there may be a more severe medical issue. Some of the most common causes include:
Chlamydia or Gonorrhea
Both chlamydia and gonorrhea are bacterial infections that cause pain, discharge, or other symptoms. They can affect both men and women. Both can lead to long-term health problems if left untreated. If a woman with chlamydia or gonorrhea gets pregnant, the infection can spread to the fallopian tubes and ovaries. This can lead to pelvic inflammatory disease (PID) and infertility. Women with chlamydia may also develop abnormal bleeding during intercourse or a low-rising uterus.
In men, gonorrhea or chlamydia can infect the urethra and the tubes that carry semen to the penis. This can cause pain or burning when you urinate or ejaculate. In addition, gonorrhea can cause a painful condition called epididymitis. This is the inflammation of a tube that holds sperm in place in the penis. Gonorrhea can also cause a prostate gland infection, called prostatitis.
A doctor can diagnose chlamydia and genital gonorrhea by asking personal questions, doing a physical exam, and taking a sample of fluid from the vagina or penis. A doctor might also order a blood test or a urine test. If you have a positive result for chlamydia or genital gonorrhea, your doctor will prescribe antibiotics. Most doctors will give you azithromycin or doxycycline, depending on your type of infection. You will need to take the entire prescription, even if you start feeling better before the medication is finished. It is important not to have sex until you have completely recovered from the infection.
Inguinal Hernia
Men will wince at the mere mention of hernia, but hernias are surprisingly common. Hernias happen when part of an internal organ pushes through a weak spot in the muscle wall that forms the abdomen’s wall near the groin area. This is what causes the visible swelling or “lump” in the groin called an inguinal hernia. Men are much more likely to get this type of hernia, which may appear as a bulge in the groin (called a scrotum by some) or a pain in the groin that disappears when you lie down.
Most hernias are not dangerous, and they can usually be treated with medication. In rare cases, the protruding part of an intestine can become trapped and cut off the blood supply. This is a serious complication called an incarcerated hernia, and it requires immediate medical attention.
Men with hernias in the groin should be careful when coughing, laughing, lifting heavy objects or straining because this can cause the hernia to get bigger and more painful. Men with hernias should avoid smoking, because this increases the risk of developing a hernia. Hernia repair surgery can also cause bruising in the scrotum and penis, which could affect sexual function for a few days or weeks. There is also a risk that the hernia could be repaired in a way that damages blood vessels, nerves or the sperm tube that goes from the testicles to the urethra.
Peyronie’s Disease
Men who have Peyronie’s disease get a thickened lump or plaque on the erection tissue of the penis. This scar tissue interferes with blood flow to the erectile tissue, which causes a hard or painful erection. In addition, it can cause the penis to bend or kink, which makes penetration difficult for both partners.
Peyronie’s disease can be diagnosed by a doctor who specializes in conditions related to the urinary tract and the male reproductive system, called a urologist. Your urologist will ask you about your symptoms and do a physical exam. They may also order an ultrasound, which uses sound waves to examine the soft tissue on the penis.
Some medical treatments for Peyronie’s disease are injections of a protein that helps control swelling (interferon) and a drug called collagenase, which breaks down scar tissue. These treatments are often effective, but they can take months to work. They aren’t recommended for everyone with Peyronie’s disease, especially those with a severe curvature of the penis.
Surgery to remove the plaque isn’t available for all patients with Peyronie’s disease, but it is successful in 75% of cases. The surgery involves removing the plaque and then filling in the gap with a piece of tissue that is either taken from elsewhere on the body or bought commercially. This helps the short side of the penis become straight, but it won’t make the erection as long as it was before the disease.
STIs
There are many different bacteria, viruses and parasites that can cause STIs. They can be spread through oral, anal or vaginal sex, or by skin-to-skin contact. Symptoms vary depending on the infection. Women may have pain, bleeding or a discharge during menstruation, while males may experience inflammation of the epididymis (the tube that stores sperm), pain with defecation or urethral irritation.
STIs can be prevented by practicing safer sex, using condoms or dental dams to prevent direct skin-to-skin contact and getting tested regularly. Vaccines are also available to protect against hepatitis A and B, human papilloma virus (HPV) and chlamydia.
Both men and women should tell their sexual partners about sex-related symptoms and infections to reduce the risk of spreading them to other people. Talking openly and honestly with your partner about sex helps to build trust and respect. It can also help you to get treatment quickly, which will reduce the risk of complications such as pelvic inflammatory disease or infertility.
When you are diagnosed with an STI, your health care provider will ask personal questions about your sex history and check for the signs of the infection. They will swab or take fluid from your penis, anus or vagina and run tests on the sample to find out what infection you have and how serious it is.
