You just finished a nice romp in the hay and are feeling great. But then you notice a tightening sensation down below. What gives?
Cramping after sex can happen occasionally. But is it normal? How can you help ease the symptoms? And when should you be concerned? Below is everything you need to know:
Reasons Why You Might Experience Post-Intercourse Cramping
There are multiple reasons why you might feel stomach pains following sex. The most common ones include:
Your orgasm: “It is absolutely normal to cramp after sex, especially if you had an orgasm,” said Heather Bartos, an OB-GYN in Dallas, Texas. She added that orgasms are just spontaneous contractions of the uterine muscle and that these can continue for a brief period of time after sex has ended.
Early pregnancy: “Many women may experience crampy abdominal pain during this time in gestation, particularly exacerbated with sexual intercourse,” said Kecia Gaither, a double board-certified physician in OB-GYN and maternal fetal medicine.
Your period: Some people, according to Bartos, cramp more when having sex on their periods. “The uterus already is working hard to expel menstrual blood and so the contractions can be more pronounced during sex while on your period,” she said.
“Interestingly enough, sex can actually alleviate period pain for some, but yes, all of that action and movement ― from contractions to pressure ― can also add to your discomfort,” added Janelle Luk, a reproductive endocrinologist and co-founder of Generation Next Fertility.
You’re ovulating: Experts note that if you are ovulating, you may be more likely to feel cramping after sex.
“When you think about the physical things that happen during sex ― contractions after orgasm, and pressure on your cervix ― you can see how this could add to cramping,” Luk said. “In fact, all of the movement, pressure and activity of sex can put temporary pressure or push around everything, from your ovaries and uterus to your bladder, which can all be ‘bothered’ during sex, leading to temporary cramping.”
Your IUD: Bartos said that since an IUD is a foreign body that sits in the uterus to prevent pregnancy, any uterine movement against it can feel like significant cramping. But these types of cramps should be pretty mild.
“I think a lot of us hear ‘cramps’ and picture those horrible, debilitating, keep-you-home-from school cramps, but these are often mild contractions that are just annoying and fleeting,” she said.
Luk added that this shouldn’t cause you to worry that the act of intercourse will move around your IUD out of position. “Sex isn’t going to do that,” she said.
Your partner’s semen: Seminal fluid contains a hormone-like substance called prostaglandin, Gaither said, and some woman are sensitive to it.
“So when it is released into the vagina during ejaculation, it can cause cramping,” Luk added.
Your anatomy: Gaither explained that some people have a uterus that is “tilted such that the lower portion, or cervix, is at such an angle that when sexual intercourse occurs, your partner is hitting the cervix with deep penetration causing pelvic pain/cramping.”
A cyst: Alyse Kelly-Jones, an OB-GYN at Novant Health Mintview in Charlotte, North Carolina, stated that a ruptured ovarian cyst can also cause cramping and that sometimes the force of intercourse can rupture an ovarian cyst.
“The cyst will cause fluid to coat the abdomen and this can sometimes cause pain,” she said.
Fibroids: If you suffer from fibroids (noncancerous growths of the uterus), those tissues may be near your cervix and can cause pain after sex, Luk noted.
“In the same vein, if you have endometriosis,” — a condition where uterine tissue grows on other pelvic organs — “you may also be more susceptible to cramping after sex,” she said.
How To Ease Post-Sex Cramps
First off, try switching up your position and the vigor of the act.
“Because we’re talking about pressure on your body during sex, think about changing your positions to try to lessen the pressure on your cervix and body, and perhaps less rigorous sexual intercourse,” Luk said, who added that emptying your bladder before sex can help to ease up on the pressure you might experience. If you suspect that you might have a sensitivity to prostaglandin, she suggested having your partner wear a condom to see if that helps.
“For mild cramping, I would recommend a patient pretreat with 800 mg ibuprofen. Having this medication on board prior to sex can help to prevent this type of cramping,” Kelly-Jones said. Other over the counter options include Tylenol, Aleve and Motrin, as prescribed.
You can also attempt to ease post-intercourse discomfort by “taking a nice, hot bath or using a heating pad,” Luk said. “Because we’re trying to calm the contractions and tension, you may also want to try some natural remedies like stretching or deep breathing to promote relaxation in that area.”
When To Be Concerned
While many causes of cramping after sex are nothing to be concerned about, experts point out that there are some symptoms to be aware of.
“In some cases, underlying pelvic or urinary tract infection, endometriosis or pelvic masses including ovarian cysts and even ectopic pregnancy may help explain cramping,” said Jill Rabin, chief of ambulatory care, obstetrics and gynecology at Long Island Jewish Medical Center in New Hyde Park, New York.
Rabin said the difference lies in the severity and nature of the cramping sensation. “If cramping only occurs at the time of orgasm, it’s likely nothing to worry about. If, on the other hand, the symptoms occur at other times and especially if the woman has a history of endometriosis, exposure to a new partner or ovarian cyst, this may speak to the other causes,” she added.
Luk said the most important thing is to listen to your body. “If you’ve tried some of the solutions and they simply are not working, if the pain doesn’t dissipate, or if it keeps getting worse, if it’s accompanied by symptoms like bleeding or dizziness, or if the pain is severe and uncomfortable, it’s important you advocate for yourself and speak to your doctor,” she said.
It’s important to establish a trusting relationship with a physician whom you can speak with and bring your questions to, Rabin said. And pay attention to when the cramping occurs. “Keeping a symptom diary is often very effective,” she said. “Bring it with you at the time of your visit.”
Rabin’s final caveat is to remember that most of these symptoms do not represent a serious underlying condition, but “do not ignore persistent symptoms and go see your doctor.”
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