Why Does My Lower Stomach Hurt After Sex?

Pain after or during sex can be uncomfortable to talk about and challenging to bring up to your doctor. Advocating for your health is important, which sometimes means having awkward conversations. If you're experiencing pain after sex in your lower abdomen, there could be several different, treatable reasons you're experiencing this pain. You'll probably not shock your ob/gyn with anything you say or ask. Your medical team needs to know if you're experiencing discomfort or pain after sex.

Why Does My Lower Stomach Hurt After Sex?

It's not normal for sex to be painful. Your medical provider isn't getting the complete picture of your health if you're leaving out symptoms that cause discomfort where there shouldn't be any. It's essential to address the issue of painful sex, particularly if you're a woman experiencing lower abdominal pain during and after intercourse, so your doctor can help you rule out any underlying severe diagnostics.

What Causes Lower Stomach Pain After Sex?

Experiencing pain in the lower abdomen after sex might indicate some issues in the pelvic region, where the reproductive organs are located. Here are some usual reasons for this discomfort, mainly linked vaginal or uterine problems:

Vaginal Dryness

Vaginal dryness can make sex uncomfortable and is one of the most prevalent causes of lower abdominal pain post-sex. Symptoms of vaginal dryness include burning and irritation of the vulva and vagina. Vaginal dryness is often associated with hormonal imbalances affecting estrogen levels and is a common symptom of menopause and a side effect of birth control. Your menstrual cycle can also cause vaginal dryness because of hormonal changes during your period. Talk to your doctor if you're on birth control and experiencing vaginal dryness, as they may be able to change your prescription to a more suitable medication.

Ovarian Cysts

The formation of cysts, benign pockets filled with pus, fluid, or air, can occur in various parts of the body, including the ovaries. Ovarian cysts, while generally common, may lead to dull or sharp pain in the lower abdomen, especially after intercourse. If these cysts persist without resolution, the pain may intensify. According to the National Library of Medicine, when left untreated, ovarian cysts can rupture and cause hemorrhaging and torsion when the tissues and organs surrounding the cyst become inflamed and twisted, cutting off the blood supply.

Menstruation

Menstrual cycles commonly cause discomfort and pain in the lower abdomen. Tight, heavy pelvic pain before or during menstruation, as well as severe cramping associated with premenstrual syndrome (PMS), can be exacerbated by sexual intercourse at specific times during the menstrual cycle. Tell your provider if you're experiencing any severe menstrual symptoms that are impacting your daily routine, such as extreme pain and fatigue, heavy bleeding, or irregular periods.

Inflammatory Disease

Pelvic inflammatory disease (PID) emerges as a serious cause of post-sex lower abdominal pain, primarily resulting from untreated sexually transmitted infections (STIs). PID affects female reproductive organs, causing mild to severe pelvic and lower abdominal pain, often worsening after intercourse. If discovered early, pelvic inflammatory disease can be treated with antibiotics, which is why STI testing is essential for your health and well-being.

Fibroids

Uterine fibroids are growths in the muscular wall of the uterus. Fibroids are abnormal growths within the reproductive tract that grow in or on the uterus. They're typically benign growths that can cause intense pain, discomfort, bloating, and heavy periods. Lower abdominal pain after intercourse may indicate the presence of fibroids. While common, occurring in 20% of women, fibroids are a painful and uncomfortable condition that should be addressed with your provider. 

Endometriosis

Endometriosis is a painful disorder caused by endometrial tissue growing outside the uterus. This condition affects the fallopian tubes, ovaries, and pelvic lining, causing pain during menstruation and, notably, painful intercourse in the lower abdomen. Endometriosis is a progressive condition that requires treatment to prevent complications. 

Vulvodynia

Vulvodynia is a persistent discomfort or pain in the vulva. Most cases of vulvodynia come on without warning and don't have any apparent cause. The associated pain, burning, or irritation can be so intense that prolonged sitting or engaging in sexual activity becomes challenging. This condition may endure for months to years. 

Vaginismus

Vaginismus is pain during sex caused by involuntary muscle contractions in the pelvic floor muscles, specifically those surrounding the vagina. These contractions can make it difficult or even impossible for individuals to engage in vaginal penetration, leading to pain and discomfort. Various factors, including anxiety, fear, trauma, or previous painful experiences, can trigger vaginismus. Patients experiencing vaginismus do not have control over the muscles and cannot prevent it from happening. Vaginismus is a treatable condition, and seeking professional help from a healthcare provider or a pelvic floor physical therapist is crucial. 

Pelvic Floor Dysfunction

Pelvic floor dysfunction occurs when the pelvic floor muscles, responsible for regulating bowel and bladder functions, remain tense instead of relaxing. Common symptoms include difficulty with bowel movements, incomplete evacuation, and leakage of urine or stool. Factors contributing to this dysfunction include traumatic injuries, pregnancy, pelvic surgery, excess weight, and age. Pelvic floor dysfunction may also be genetic, which is why it's important to discuss your family history with your provider. This will give them a more comprehensive picture of your health and any potential risks.

Urinary Tract Infection

Urinary tract infections or UTIs occur when bacteria enter the urinary tract, leading to infection. During sexual intercourse, bacteria from the genital area can be introduced into the urethra, increasing the risk of UTIs. Symptoms may include a burning sensation during urination, frequent urges to urinate, and pain or discomfort in the lower abdomen. It's essential to practice good hygiene, such as urinating before and after sex, staying hydrated, and wearing breathable underwear. Tell your ob/gyn if you're having symptoms of a UTI, as most infections are cleared up with antibiotics.

Talking to your Doctor About Pain After Sex

Your lower abdominal pain after sex may be the result of vaginal dryness or PMS symptoms or even the result of being in the wrong position. Home remedies for these symptoms include:

Using Lubricants: Incorporating gentle lubricants during intercourse can effectively alleviate symptoms associated with vaginal dryness.

Positional Adjustments: Experimenting with different sexual positions with your partner can contribute to reducing discomfort during and after intercourse.

Over-the-counter Pain Relief: Ask your doctor if taking over-the-counter pain relievers can help with your post-intercourse pain.

If you don't see relief from these self-care measures and the lower abdominal pain persists, talk to your ob/gyn.

If lower abdominal pain persists and becomes severe, seeking immediate medical attention is crucial. Conditions such as ovarian cysts, which may lead to internal bleeding if ruptured, require prompt intervention, particularly if exacerbated by sexual intercourse.

When To See a Vascular Specialist for Abdominal Pain After Sex

Vascular surgeons specialize in maintaining the efficiency of veins, arteries, blood cells, and the circulatory system. There is a chance your lower abdominal pain is related to varicose veins in the upper thigh or vaginal region. In that case, it is advisable to consult a vascular doctor instead of a gynecologist, as your pain could be caused by pelvic congestion syndrome or PCS. Pelvic congestion syndrome is caused by damaged veins in the pelvis, which allow blood to pool, causing inflammation and swelling. Pain tends to intensify after long periods of standing or sitting. You should see your gynecologist to rule out any other underlying conditions before referring to a vascular specialist.

Symptoms of pelvic congestion syndrome include but aren't limited to:

• Painful and heavy menstrual cycles
• Pelvic pain, heaviness, pressure, aching, and bloating
• Noticeable varicose veins in the pelvis, labia, or legs

When To See a Gynecologist for Abdominal Pain After Sex

Experiencing abdominal pain after sexual activity can be a concerning and uncomfortable issue, and it's essential to know when to seek guidance from a gynecologist. While occasional discomfort after sex is normal, you shouldn't be in pain.

Make an appointment with your ob/gyn if you're experiencing any of the following symptoms:

• Severe pain that stops you from having sex
• Aversion to arousal due to fear of recurring pain
• Disruption of daily activities due to pain
• Unbearable pain during menstrual cycles
• Heavy bleeding during your period
• Spotting or bleeding between periods

Understanding the reasons behind lower abdominal pain after sex involves recognizing a spectrum of potential causes, many linked to the female reproductive system. Seeking timely medical attention is crucial to rule out underlying conditions. If no identifiable reasons are found, the pain may be attributed to pelvic congestion syndrome. Proactive engagement with healthcare professionals ensures comprehensive care and addresses potential concerns related to lower abdominal discomfort after sexual intercourse.

Pelvic Pain Treatment at Center for Vascular Medicine

At the Center for Vascular Medicine, we embrace cutting-edge diagnostic and interventional medical technology. Proudly holding a record of early diagnosis and swift treatment, we invite you to take the first step toward a healthier, more comfortable future. Your journey to well-being begins with us. Discover a haven of care at the Center for Vascular Medicine, where our expertise lies in diagnosing and treating deep venous and arterial diseases affecting the pelvis and lower extremities. 

We serve patients from Annapolis, MD, Columbia, MD, Easton, MD, Glen Burnie, MD, Greenbelt, MD, Prince Frederick, MD, Silver Spring, MD, Waldorf, MD, Fairfax, VA, Fredericksburg, VA, New Brunswick, NJ, and Union, NJ.