Stomach Pain After Sex – Is This Female Dyspareunia?

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Stomach pain after sex is pretty normal and it happens to a lot of women. But it can also indicate a few different things.

Sometimes cramping is caused by reaching an orgasm, which causes uterine contractions and can lead to stomach pain. Or, it could be a sign you’re ovulating or that you have deep penetration (yikes!).

Causes

The good news is that stomach pain after sex, in most cases, is nothing to worry about. It’s common and often attributed to fairly mundane things, like vaginal dryness or a urinary tract infection that can be exacerbated by sex (especially with anal penetration).

If your pain is accompanied by fever, itchiness, spotting, pus or a burning sensation in the area, you should call your doctor as it could indicate a more serious problem. Other causes of stomach pain after sex include ovarian cysts, pelvic inflammatory disease and uterine fibroids.

Vaginal dryness is a common cause of stomach pain after sex in women, and it usually occurs because the body’s natural lubrication is disrupted due to pregnancy, birth control or hormone changes. Occasionally, it can also occur because of sexually transmitted infections (STIs), especially chlamydia and gonorrhea.

Rough sex can also trigger stomach pain in some women because it creates muscle contractions in the pelvic floor and abdomen that can lead to cramping, Whelihan says. It’s not unusual to feel lingering stomach pain after climax, as well, which is likely caused by the uterine muscular contractions that occur during orgasm. Sometimes, the pain is a sign of a more severe issue like endometriosis, which happens when the tissue that makes up the uterus lining grows outside of the uterus—in the fallopian tubes, ovaries or even on the intestines.

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Symptoms

Stomach pain after sex, called dyspareunia, affects many women. It might not seem like a big deal, but it can be a sign of some serious issues that you should pay attention to. It might indicate a miscarriage or an ectopic pregnancy (when the fertilized ovum implants outside of the uterus). It could also be a sign of endometriosis, in which tissue from the uterus ends up on the ovaries, fallopian tubes and intestines. In addition, it might be a symptom of fibroids, noncancerous tumors that develop in or on the uterus.

Often, the pain is due to deep penetration during anal or vaginal sex. You might want to avoid sexual positions that allow for deep penetration, such as missionary or doggy style. Instead, you can try to use less-invasive sexual positions, such as on the side or cowgirl style, which can give you more control over the depth of penetration.

Cramping after sex might also be caused by orgasm. When you orgasm, the pelvic muscles contract, which can cause stomach pain in some women. This pain is usually not a big deal and goes away on its own, but it may be more intense during certain phases of the menstrual cycle or when taking certain medications such as birth control pills.

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If the pain is severe, happens regularly, or shows other symptoms, you should visit your gynecologist. The doctor can review your symptoms, do a physical exam and run tests to find the underlying problem.

Treatment

Pain is uncomfortable, but it’s even more uncomfortable to feel it after something that was supposed to be pleasurable. And while most pain related to sex isn’t serious, it’s important that anyone who experiences stomach pain after sex — regardless of the cause — seek medical help to be sure that nothing more severe than a simple infection is present.

Often, stomach pain after sex is caused by deep penetration or muscular spasms that occur when the cervix is touched during sex. However, it can also be a sign of an underlying medical issue such as uterine fibroids or endometriosis (tissue that grows outside of the uterus) or infections such as pelvic inflammatory disease or urinary tract infections.

In addition, certain STIs such as chlamydia and gonorrhea can cause pain in the lower abdomen during and after sexual intercourse. Lower abdominal or stomach pain during sex that’s a one-off event or improves with a change in position does not usually require a visit to the doctor, but any persistent discomfort should be evaluated by a health care professional, according to experts.

When the cause is determined, a gynecologist can prescribe any medications or therapies necessary to alleviate the discomfort, including pain killers, antibiotics or lubricants. For severe pain that is not subsiding, a gynecologist may suggest pelvic sonography or a hysterosalpingogram to check out the uterus, fallopian tubes, ovaries and prostate.

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Prevention

While there are many possible reasons for stomach pain after sex, most of them are benign, says Yale New Haven Hospital ob-gyn Mary Jane Minkin. Often the pain is a result of deep penetration or gas, but it can also be a sign that you’re ovulating or have a condition like pelvic congestion syndrome. Taking lubricant, over-the-counter pain relievers, and switching up sex positions can help.

Orgasms are known to cause pelvic cramping and stomach pain, Whelihan explains. “These contractions are usually the result of uterine muscular activity that happens during orgasm.” Similarly, it’s normal for abdominal muscles to hurt after doing an exercise class, especially one that involves holding difficult postures.

It’s also common for women with a history of sexually transmitted infections (STIs) to experience abdominal pain during and after sex. Getting regular STI screenings, as well as treatment for chlamydia and gonorrhea (if you have them), can prevent these problems from occurring and keep you feeling great during sex.

Other non-STI causes of stomach pain after sex are fibroids, endometriosis (tissue that normally lines the inside of your uterus growing on other organs like the fallopian tubes and ovaries) or adenomyosis (tissue that grows into the lining of the uterus). These conditions can all cause symptoms in the lower abdomen and pelvic area and may get worse during sex.

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