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.
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
1. It’s a sexual position
When 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
The 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
2. You have endometriosis
Endometriosis 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.
When 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 inflammation.
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.
3. You have an ovarian or pelvic cyst
Many 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
What to do: Your
doctor will do an ultrasound to diagnose the problem, then you might need a
laparoscopy to remove the cysts.
4. You have an infection or a past inflammatory disease
A 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 irritated area.
And 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).
5. 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.
6. You have a tilted uterus
Don’t 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
But 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
7. You have fibroids
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.
When in doubt, talk to your doctor
Whenever 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.com
Image credit: iStock