Cramping after sex can occur for a wide variety of reasons and is not always a sign of an underlying medical condition. For example, orgasm and ejaculation can cause the release of substances called prostaglandins, which cause muscle contractions that may feel like cramps. In most cases, the pain is temporary and fades away on its own.
However, if you are frequently experiencing pain after sex, you may want to seek medical advice. Contact your doctor if you experience:
- Severe pain that interferes with your sexual life
- Increasing pain intensity
- Bleeding or spotting during or after sex
- Lesions or bumps in your genital area
- Foul-smelling vaginal discharge
- Uncontrolled or involuntary contractions of the vaginal muscles
- Irregular or heavy periods
- Unexplained loss of weight
- Cramping during or after sex in pregnancy
What causes cramps after sex?
Causes of cramps after sex may include:
- Sexually transmitted infections (genital herpes, human papillomavirus, chlamydia, or molluscum contagiosum)
- Pelvic inflammatory disease (infection of the uterus, ovaries, or fallopian tubes)
- Vaginal dryness due to menopause, hormonal changes, medications, or insufficient foreplay
- Fibroids or leiomyomas (noncancerous growths arising from the muscle layer of the uterus or cervix)
- Endometriosis (a medical condition in which the endometrium or tissue that lines the inner surface of the uterus grows elsewhere in the body)
- Vaginismus (involuntary contraction of vaginal muscles)
- Retroverted uterus or tipped uterus (an abnormality in the anatomical position of the uterus where the uterus is tilted backward)
- Psychological factors (stress, anxiety, or fear related to sexual intercourse)
- Imperforate hymen (a condition in which the hymen blocks the entire vaginal opening)
- Skin conditions in the genital area (eczema or intertrigo)
- Inflammation of the urethra (urethritis) or urinary bladder (cystitis)
- Ovarian cysts
- Uterine prolapse
- Radiation or chemotherapy
- Previous surgeries (such as hysterectomy and myomectomy)
- Following intrauterine device (IUD) insertion
- Following childbirth
- Cervicitis or cervical erosion
- Cancer (rare)
How to treat cramps after sex
Treatment of cramps after sex depends on the cause or underlying health condition. Your doctor will take a detailed medical history, perform a physical examination, and order relevant investigations to confirm a diagnosis.
- If no underlying medical condition is found, the cause of cramps may be due to psychological factors, for which counseling may be recommended.
- If an infection is causing your symptoms, your doctor will prescribe antimicrobial medications (antibiotics, antifungal, or antiviral medications depending on the cause of infection).
- Hormone replacement therapy may be advised if menopause is causing your symptoms. Ospemifene is an oral medication approved by the FDA to treat painful intercourse in menopausal women.
- If certain medications are causing vaginal dryness, your doctor may prescribe suitable replacements for the medications.
- For vaginal dryness, your doctor may recommend topical estrogen or vaginal lubricants.
- Skin conditions may be addressed by suitable therapy prescribed by a dermatologist. Your doctor may advise you to avoid synthetic panties, vaginal douching, or the use of fragrances, including scented creams, pads, or toilet papers in your genital area.
- Surgery may be needed to treat certain conditions, such as fibroids or endometriosis.
Your doctor may also recommend some home-management tips, such as:
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Heim LJ. Evaluation and Differential Diagnosis of Dyspareunia. Am Fam Physician. 2001 Apr 15;63(8):1535-1545. https://www.aafp.org/afp/2001/0415/p1535.html
Cleveland Clinic. Dyspareunia (Painful Intercourse). https://my.clevelandclinic.org/health/diseases/12325-dyspareunia-painful-intercourse