There are a few reasons why your muscles may feel sore after sex. Some are easy fixes, like using extra lube or switching sex positions. Others are more serious, like a yeast infection or an STI.
In some cases, leg pain after sexual activity could indicate an underlying condition that requires medical evaluation and treatment. Treatment for these conditions can include lifestyle changes, medication, and/or surgery.
Muscle strain
A muscle strain, or pulled muscle, occurs when you stretch a muscle beyond its comfortable range and the fibers start to tear. Muscle strains can be mild, moderate or severe. They are one of the most common injuries and can be treated at home with rest, ice, compression and over-the-counter pain medications.
A strain can occur in the muscle or a tendon (fibrous cords of tissue that connect muscle to bone). Many things can cause a strain, including falling or blows to the muscles, not warming up before physical activity and over-stressing your muscles. 1
Your healthcare provider will diagnose a muscle strain with a physical exam. They may also order imaging tests to assess the extent of your injury, such as an MRI or ultrasound. If you are prone to muscle strains, you can prevent them by properly warming up before exercise and stretching before lifting heavy objects.
Cramps
Cramps are an involuntary contraction of a muscle that feels like a tight ball or knot. They can result from sexual activity, as well as other causes of pain such as gynecological problems, bladder infections (interstitial cystitis) and urethral strictures.
Muscle tissue relies on a healthy balance of minerals and electrolytes to contract and relax. A disruption in this balance, such as a dehydration or an imbalance of calcium, magnesium and potassium, can make muscles more vulnerable to cramping. Other risk factors include vomiting and diarrhoea, which can disturb the normal balance of these essential nutrients.
Cramping after sex can also be caused by nerve compression or poor body positioning. This can be alleviated by using positions and movements that do not put pressure on the muscles or nerves. It is also important to stay hydrated before, during and after sexual activity, and to incorporate stretching and strength training exercises into your routine.
Adrenal dysfunction
The adrenal glands, located above the kidneys, produce hormones that control blood pressure and how your immune system works. Symptoms of adrenal dysfunction include fatigue and weakness. Adrenal insufficiency, also called Addison disease, is when the glands don’t make enough hormones. It may be caused by autoimmune diseases or suddenly stopping steroid medicines used to treat other conditions.
Supporters of the idea of adrenal fatigue claim that long-term stress causes the glands to break down and not produce sufficient cortisol, a hormone that helps with energy production. However, no scientific proof exists that the condition actually exists. In addition, any treatments suggested by advocates are not reviewed or approved by the U.S. Food and Drug Administration, and most insurance companies do not cover the costs of these unproven remedies.
The adrenal glands can be triggered by sexual activity to trigger a “spell” of high blood pressure, headache, sweating and chest or abdominal pain. A common cause of these episodes is pheochromocytoma or paraganglioma, which are benign tumors in the adrenal glands. X-rays, computed tomography (CT) scans and magnetic resonance imaging are used to diagnose these rare conditions.
Vascular spasms
Vascular spasms occur when a blood vessel suddenly tightens or narrows. This reduces the amount of oxygen that gets to the area it supplies, causing pain and sometimes damage. The problem can happen anywhere in the body, but it is most common in the fingers and toes (Raynaud’s phenomenon), the heart (cardiac vasospasm), or the nipples (nipple vasospasm).
Your arteries expand and contract their muscular walls regularly to help control the pressure of blood flowing through them. If a spasm lasts too long, it can damage the layers of tissue that line the artery wall. It also cuts off blood flow to the tissue, causing ischemia (injury due to lack of oxygen).
A doctor can diagnose vasospasms by observing your symptoms. They may order tests to find the cause, including an ultrasound with Doppler that looks at blood flow and a CT angiogram, which injects dye into your artery and views it with an X-ray. Medicines that help blood vessels relax, such as calcium channel blockers like verapamil or diltiazem and ACE inhibitors, can be used to treat this condition.
Radiculopathy
Pain and numbness in your arms or legs may be caused by compressed spinal nerves (radiculopathy). In most cases, this is caused by herniated or bulging discs that narrow the space through which a nerve passes. Spinal foraminal stenosis may also be caused by bone spurs — areas of extra bone growth that form in response to inflammation and osteoarthritis.
Radiculopathy can occur in your neck or your lower back, depending on where the pinched nerve is located. Symptoms of cervical radiculopathy, which occurs in the neck, can include pain, weakness and numbness in your arm or hand. Symptoms of lumbar radiculopathy, which occurs in the lower back, can cause pain in your legs or feet, and loss of control over specific muscles.
Your doctor can diagnose radiculopathy by doing a physical exam and reviewing your symptoms. He or she will examine your neck and spine, take X-rays and/or computed tomography (CT) scans and perform a test that uses electrical impulses to determine how well your nerves are functioning.
Muscle imbalances
Muscle imbalances are the root cause of many workout-related injuries and pain. The problem occurs when one group of muscles is stronger, shorter, or tighter than the other. This imbalance causes problems with posture, balance, and movement, increasing the risk of injury and pain.
Muscles in the body are designed to counterbalance each other, so that when one muscle becomes weaker, the opposite muscle can pick up the slack. This prevents overuse of one muscle and helps keep the joints healthy.
However, repeated movements or holding a certain posture can make one muscle group more dominant than the other. This is often the case in athletes who use one side of their bodies more for their sports; tennis players, golfers, and figure skaters are examples.
Often, these imbalances can be corrected through specific exercises that target short muscles and long ones. Exercises like the Bulgarian split squat, single-arm dumbbell rows, and unilateral deadlifts help to prevent the dominant muscles from overtaking the weaker ones.
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