Pain with sex is not normal and should be treated promptly. Cramps during or after sex could be due to a number of medical conditions.
In males, pelvic pain may indicate STIs like chlamydia and gonorrhea. Symptoms of these infections include painful ejaculation and pelvic pain.
Men can also experience pain with sex because of a hernia, which occurs when tissue pokes through an abdominal muscle. Treatment includes surgery and pain medication.
1. Sexually Transmitted Infections
Sexually transmitted infections (STIs) are caused by bacterial or viral bacteria that are spread during vaginal, anal or oral sex. They’re common and can cause serious health problems if they aren’t treated.
A health care provider can diagnose STIs with a physical exam and tests. They’ll ask questions about your sex history — it’s important to be honest so you get the right treatment. They may take a sample of fluid from skin sores, a sample of your urine or blood to find out which STIs are present.
Chlamydia trachomatis (C. trachomatis) is one of the most common causes of pelvic pain and other symptoms in men and women who are sexually active. It’s a bacterial infection that causes genital warts or painful, swollen sores in the vulva or urethra. Chlamydia is easily treatable with antibiotics.
Gonorrhea is another common STI. It’s a bacterial infection you can get from having unprotected sex with many partners. It’s usually easy to treat with antibiotics, like metronidazole or tinidazole. Viral STIs, like herpes, aren’t curable but they can be treated with drugs to prevent the virus from spreading and causing more severe symptoms. It’s a good idea to get tested for all types of STIs if you have risk factors, like having many sexual partners or being young and sexually active.
A hernia is a bulge of tissue that pushes through a weak spot in your muscle. Usually, it occurs in the groin area and is called an inguinal hernia. Hernias can be caused by testicles descending after birth and the inguinal canal not closing correctly. People with hernias can have pain during and after sex, especially when straining occurs.
A hernia can affect both men and women, but it’s more common in males because hernias are often caused by sports or heavy lifting. They can also happen if there isn’t enough lubrication during sex.
Hernias can get worse the longer they’re ignored. It’s best to see your doctor to talk about treatment options, which may include hernia surgery.
During a sex orgasm, your pelvic muscles contract intensely and can cause cramping. However, this type of pain is different from regular sex pain. It’s important to see your doctor if you have pain after sexual activity, because it could be a sign of an underlying medical condition. Your healthcare provider will perform a physical examination and might order imaging tests such as an MRI or ultrasound. You might also have a digital rectal exam (DRE). These are simple tests that can help detect a hernia. If your doctor suspects you have a hernia, they will perform a hernia repair.
3. Urinary Tract Infections
The STIs gonorrhea, chlamydia, and mycoplasma can lead to painful pelvic conditions called urinary tract infections (UTIs). These are when bacteria get into the bladder, vagina, or urethra. They can cause symptoms such as a burning feeling when you urinate, a frequent and urgent need to urinate, and pain in the lower abdomen, pelvis, or genital area.
Women are more prone to getting UTIs than men because they have shorter urethras, which means that bacteria have less distance to travel before reaching the bladder. Having new partners or going through menopause can also increase your risk, since changes in the lining of the vagina or uterus can make it easier for bacteria to get in and grow.
In males, a UTI can also affect the testicles or penis and can be felt as pain in the scrotum, vulva, or the head of the penis (called dyspareunia). Cramps during orgasm are usually due to spasms of the pelvic floor muscles, but pain after orgasm isn’t necessarily a sign of an infection.
If you have pelvic pain, see your healthcare provider as soon as possible. If it’s related to sex, your healthcare provider might refer you to a gynecologist, urologist, or sex therapist. If you have a UTI, your healthcare provider will prescribe antibiotics to help fight the infection and clear up your symptoms.
Prostatitis is an infection and inflammation (swelling) of the prostate gland. The prostate is a chestnut-sized organ below the bladder and in front of the rectum in men. It produces one of the fluids that make up semen and helps push sperm into the urethra during ejaculation. Bacterial infections can cause prostatitis, but STIs do not cause most cases of the condition. Prostatitis can be painful and bothersome, but it does not cause cancer and doesn’t increase the risk of a hernia or urinary tract infections.
The symptoms of prostate problems can be similar to those of other conditions, so it is important to see a doctor for a diagnosis. A doctor will ask about your health history and do a physical exam. They will use a digital rectal exam, which involves inserting a gloved finger into the rectum to feel for a swollen, tender or hard prostate. They may also take urine or blood samples for testing.
Acute bacterial prostatitis is the least common type of the infection. It happens at any age and causes severe pain in the penis and testicles and painful urination. This is treated with antibiotics and fluids. If your symptoms persist, you might have chronic bacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS). This is more common and doctors don’t always know what causes it. The symptoms are similar to acute bacterial prostatitis, but they last longer and you usually don’t have a fever.