Pelvic Pain After Sexual Activity

Men who suffer from pelvic pain after sexual activity may feel achy, sore or uncomfortable. If this pain is recurring, it could be the sign of a serious medical condition.

Acute pain after sex is not unusual, but it usually disappears on its own. If it doesn’t, it is important to consult a urologist for help.

Causes

In fantasy land, sex is all orgasmic pleasure and post-sex cuddles. But for many men, pelvic pain after sexual intercourse is the reality. Pain during sex can trigger performance anxiety and diminish interest in the activity. It is also often the first sign of a serious medical condition.

Pelvic pain affects the lower abdomen and buttocks, but the exact location of the pain depends on the cause of the problem. The pain can be felt in a small area or throughout a large area, feel like pressure or be sharp or dull.

For example, an infection of the vulva (uterus) or vagina may cause pain during sexual intercourse. This can be due to a herpes sore, genital warts or other STIs. A bacterial infection of the anus or rectum, called prostatitis, can also cause painful intercourse. It is often accompanied by a fever and pus in the urine.

It is also possible to have painful ejaculation from certain medications, such as antidepressants. This is especially true of imipramine, desipramine, clomipramine and protriptyline, but can also occur with fluoxetine and venlafaxine.

Sometimes, the pain is caused by deep penetration. This can happen when the cervix and uterus are repeatedly bumped during sex, which causes the shock to spread through the pelvic ligaments. Over-the-counter lubricants and changing the depth of penetration can help.

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Symptoms

Cramps during or after sex aren’t unusual and don’t necessarily indicate that something is wrong. They could be a sign of an orgasm or simply from the pressure of having sex. However, pain that continues after orgasm and during penetration is often caused by an underlying medical condition. This type of pain is called dyspareunia. It’s more common in women than men, but it can happen to either sex partner.

In women, the pain usually occurs at the vulva or lower abdomen. It may also occur deeper into the vagina or the uterus. The pain is often aggravated by certain sexual positions or by sex that requires deep penetration.

Pain during sex can also be a sign of a yeast infection, which causes itching and thick white discharge. Treatment with prescription or over-the-counter antifungal medicine should relieve the pain.

In men, pelvic pain is most likely to result from a urinary tract infection or a sexually transmitted disease like chlamydia or gonorrhea. These infections can cause inflammation of the prostate, which makes penetrative sex painful or uncomfortable. In some cases, the infection may spread to the bladder and urethra, which can also make urinating difficult or painful. Another cause of pain in the genital area is chronic pelvic pain syndrome, which isn’t a disease but rather a collection of symptoms including painful or itchy penis (balanitis). It affects about 15 percent of the U.S. population.

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Treatment

The pain can be triggered by almost anything that presses against the vulva. This includes any kind of tampon or cotton swab, tight jeans, toilet tissue, and, of course, penetration during sex. It can also be caused by a vulvar injury such as a cut during childbirth or surgery to repair a hernia. It can also be the result of a chronic pain syndrome in the vulva called vestibulodynia.

Whether the pain is sexual or not, it should be treated as soon as possible to prevent infection. A gynecologist can diagnose the cause and provide treatment.

A gynecologist can check for the most common causes of pelvic pain during sex, including:

1. Entry pain (intraorbital dyspareunia): Pain felt at the entrance to the vagina during penetration. This can be due to lack of lubrication, injury or infection. It can also be a sign of an STI such as chlamydia or gonorrhea. This can lead to inflammation that makes penetrative sex painful or itchy. It may also cause itching, thick white discharge or pain when you pee.

2. Pain during or after ejaculation: Pain or itching in the penis, painful urination and burning during and after sex. It can be caused by infections, over-the-counter or prescription medications, or side effects from taking a hormone-based contraceptive pill or an erectile dysfunction drug. It can also be a symptom of enlarged prostate or prostate cancer.

Prevention

Pain during sex is not normal and is a sign of a medical problem. It is important to talk to your doctor about it. Your doctor will do a physical exam and ask you questions about your sexual history and any problems you have had with your penis or vagina. He or she will also check your abdomen and pelvic area. Your doctor will want to know if the pain occurs with every partner and sexual position. He or she will also look for signs of genital problems such as warts or sores.

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Male pelvic pain is most often caused by a condition called prostatitis. This is inflammation of the prostate, a walnut-sized gland in the front of the groin and anus that sits below the bladder. The prostate produces much of the fluid that makes up semen, which is then released during ejaculation. Prostatitis is most common in older men. It may be caused by infection, a urinary tract infection (UTI), or an STI.

Infections such as herpes, gonorrhea and chlamydia may cause pain during sex if they have developed into pelvic inflammatory disease (PID). PID is an infection of the reproductive organs and gut that causes painful intercourse. It can also lead to a loss of pleasure and interest in sex and can cause pelvic pain and abdominal pain. If you have a sexually transmitted infection, your doctor can treat it with antibiotics.

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