If you’re experiencing
stomach pain after sex, you’re probably wondering what the eff is going on – and
how to make it stop, like, yesterday. Obviously, any kind of stomach discomfort
sucks, but it feels especially unfair when you’re doubled-over in pain after
something that’s supposed to be, well, pleasurable.
Dr Mary Jane Minkin, an obstetric-gynaecologist at Yale New Haven Hospital, is quick to clarify that
what you might think of as just “stomach pain” is actually “lower pelvic pain”.
That’s because pain associated with sex tends to be “more towards the vagina
rather than up at the abdomen”, but people can interpret it as pain in the
abdominal cavity area. So, the next question is, WHY?
a sexual position
patients see Minkin about pain after sex, she first asks them what position
they do most. If you always have pain after missionary or doggy style, it could
be because of the deep penetration.
What to do: First try
over-the-counter pain medications. “Taking one or two an hour before sex can be
very helpful for some women,” says Minkin. She also recommends trying a
position where you’re on top, such as cowgirl or face-off, and seeing what
key is choosing a position where you have more “control over the depth and
frequency of penetration”, explains Dr Ja Hyun Shin, director of the pelvic
pain clinic in the department of Women’s Health and Obstetrics & Gynecology
at Montefiore Health System. She suggests trying a sideways position, like spooning,
that allows for more shallow penetration.
Read more: 8 reasons why you’re having painful sex
happens “when the lining of the uterus (womb) grows outside of the uterus”,
according to the Office
on Women’s Health. Pelvic pain during and after sex is one of
the most common symptoms of the condition, Shin says.
you have a severe form of endometriosis of the pelvis, you can have dense
adhesions (translation: pelvic tissues and organs sticking to each other) in
the pelvic area. “Deep penetration [during sex] can cause severe pain because
all your organs are kind of adhered together,” she explains. But you can
also have pain without these adhesions since endometriosis causes pain from
What to do: Go to your gynae. Even
though you’re having stomach pain, your doc will probably ask you about your
overall history with vaginal pain. Do you have pain with your periods? Are you
bleeding heavily? She may then suggest an ultrasound or laparoscopy, a minor
surgery to examine your pelvis. That’s the only way, Shin says, to diagnose
endometriosis for sure. To treat it, your doc will likely prescribe you birth
control pills or new endometriosis medications.
have an ovarian or pelvic cyst
women have ovarian cysts – fluid-filled sacs or pockets in an ovary or on its
surface – at one time or another. Most are harmless and disappear without
treatment after a few months, but some can continue to grow and cause pain. And
pelvic cysts are a bit different. Shin explains that a pelvic cyst can develop
from pockets of adhesions from previous surgeries or possibly an infection
where fluid collects in the pelvic area. “Think of the whole pelvis and vagina
area as one unit,” she says. “Sex can cause pain in other areas of the pelvis.”
What to do: Your doctor will do an
ultrasound to diagnose the problem, then you might need a laparoscopy to remove
Read more: These 2 treatments will change your life if you experience painful sex
have an infection or a past inflammatory disease
vaginal infection from bacteria normally found in your vagina or from a
sexually transmitted disease, such as chlamydia or gonorrhoea, can spread from
your vagina to your uterus, fallopian tubes, or ovaries (a.k.a. pelvic
inflammatory disease). As if an infection weren’t bad enough, it tends to give
you vaginal pain and pelvis pain. This pain is pretty much constant,
Shin says, but “sex can worsen it” because you’re irritating an already
get this – you don’t even need to have a current vaginal infection to have this
kind of pain. According to Minkin, a previous pelvic inflammatory disease can
cause post-sex pelvis pain if it left pelvic scarring.
What to do: If it’s an infection,
you just need a round of prescription antibiotics. But if it’s a previous
pelvic inflammatory disease, your obstetric-gynaecologist may need to prescribe
pain medications or cut down the adhesions (during a laparoscopy, for example).
You’re experiencing vaginal dryness
Minkin says certain birth control
pills can cause dryness, noting that a higher dose of
oestrogen can be helpful. And if you’re heading toward menopause, you can
probably blame that.
What to do: Grab some
over-the-counter lube. If that doesn’t work, ask your doctor about prescription
options. Minkin says vaginal oestrogen and/or vaginal DHEA (the hormone
dehydroepiandrosterone) medication can do the trick.
have a tilted uterus
freak out. “At least 30% of women have a uterus that tilts backwards, so
it’s not abnormal,” says Minkin. “Now, if there is scarring there that holds
the uterus in that position, well, then that would be painful.”
if it’s not abnormal, then why the heck does a tilted uterus cause stomach
pain? Minkin explains that doctors don’t really know, but they think it’s
because the scarring attaches organs to other organs – ones that, uh, shouldn’t
be attached – and they can get hit during sex. Basically, it’s gonna hurt if
your intestines are attached to the top of your vagina. And if your intestines
are attached to your uterus by scar tissue, they can get pushed or pulled
during sex – and that’s pretty painful.
What to do: Your doctor will tell
you if your uterus is just naturally tilted, or if it could be the result of
scarring. If there’s no scarring, try a sex position with more shallow
penetration. If it’s scarring, it’s likely due to endometriosis. Your doctor will
know how to treat that.
Read more: 10 reasons why you’re crying during sex
While fibroids are
benign (non-cancerous) tumours of the uterus, they “may cause pain during
intercourse depending on their size and location in the uterus,” says Shin.
They can also cause muscle cramping, which may explain why you’re having
pelvic pain after sex.
What to do: See your doc for an
ultrasound or an MRI of the pelvis, then discuss treatment options from there.
They range from an IUD to a hysterectomy.
doubt, talk to your doctor
you have pain in the pelvic area, both Minkin and Shin recommend talking to
your gynaecologist. “It’s an important time to go in and [get an] exam because
there are a variety of serious conditions that, if left undiagnosed, can lead
to more pain in the future,” says Shin.
This article was originally published on www.womenshealthmag.
Image credit: iStock