11 Causes of Cramps After Sex, According to Doctors

When you’re on your period, you expect to be planted on the couch with a heating pad in one hand, Motrin bottle in the other. But cramping after sex? That’s a red flag. “These cramps are usually felt in the lower pelvis, vagina, or even rectal area,” explains Alyssa Dweck, M.D., OB-GYN, author of The Complete A to Z for Your V, and sexual reproductive health expert for INTIMINA.“They can be fleeting for a few seconds or longer duration, intermittent or constant, and vary in intensity.”

Cramps after sex do happen, Dweck adds, and they’re not always cause for concern—but there are some cases where the pain warrants investigation and treatment, so it shouldn’t be ignored.

“Unfortunately, many women who experience pelvic pain are either afraid to speak up or have had their pain dismissed,” says Barbara McGuirk, M.D., a board-certified reproductive endocrinologist, endometriosis specialist at CCRM Fertility, and medical director of reproductive surgery at RADfertility. “It happens much more often than we think because it is a difficult topic to actually talk about, especially with your partner. Never feel bad about reaching out to a doctor, and if necessary, seek a second opinion.”

Ahead, doctors explain common causes of cramps after sex, along with more serious triggers, and what to do if you notice them.

Orgasm

Dr. Dweck says it’s not uncommon to feel lingering cramps after climaxing. “These are usually a result of uterine muscular contractions which naturally occur with orgasm,” she adds. They should go away after a few minutes with some deep breaths and rest. If they don’t, the culprit could be more serious, so don’t hesitate to reach out to your OB-GYN.

Urinary tract infection (UTI)

“Occasionally, cramps after sex might indicate an infection, including a vaginal infection or urinary tract infection,” says Dr. Dweck. According to the Centers for Disease Control and Prevention (CDC), cramping and pressure in the lower abdomen is a common UTI symptom, so it’s unsurprising that the pain could be exacerbated by sex.

Vaginal dryness

Dr. Dweck says vaginal dryness, perhaps caused by menopause or medication side effects, can cause cramping after sex. There’s no shame in using natural or water-based lube to keep things moving smoothly and pain-free.

Ovarian cysts

An ovarian cyst can become ruptured or leak during sex, says Dr. Dweck, and can cause enough pain to warrant a doctor’s or emergency room visit. Ovarian cysts are fluid-filled sacs that form on the ovary, one of a pair of glands where eggs form within the uterus, according to the Office on Women’s Health (OASH). They can cause dull or sudden sharp pain in the pelvis and/or abdomen.

Endometriosis

“The majority of women who have pain during sex are women who have endometriosis,” says Dr. McGuirk. Endometriosis is a condition that occurs when cells similar to the lining of the uterus—called the endometrium—grow in other areas of the body, such as the pelvis, ovaries, or abdomen, she explains. “Over time, the irritation caused by these cells can create scar-like tissue called adhesions that can twist and tie the organs into unnatural positions, causing severe pain and in some instances, infertility,” McGuirk adds.

Pain during and after sex is the second biggest indicator of endometriosis, McGuirk says, behind painful menstrual cycles. If you experience either, she recommends seeing a trusted health care provider. Endometriosis treatment varies on the severity of the condition, but scar tissue can be either surgically removed or burned away (also known as ablation). Even then, some patients may continue to develop further endometriosis lesions until they complete menopause, Angela Chaudhari, M.D., chief of gynecology and gynecologic surgery at Northwestern Medicine previously told Prevention.

Premenstrual syndrome (PMS)

This one is a given, but if you know you’re approaching that time of the month, cramps after sex (and in general) are expected, says Dr. Dweck. This is also the case if you have sex on your period. To find relief, stick to the tried-and-true methods: over-the-counter pain relief and a hot pack or warm shower.

IUD

An intrauterine device (IUD) is a T-shaped device inserted in the uterus as a form of long-term birth control. It’s normal to cramp and spot if you recently got one inserted or removed, according to Planned Parenthood. If the pain persists for more than a few months, make a doctor’s appointment.

Rough Sex

“From time to time, cramps can occur due to more rigorous sex or experimenting with different positions, especially if anatomy necessitates,” like if you have tilted uterus, says Dr. Dweck. Pay close attention to how your pain levels change as you and your partner roll around, and adjust accordingly.

Prior surgeries

“Any prior [abdominal] surgery, including a C-section, can cause discomfort and pain during sex,” says Dr. McGuirk. Relief may be as simple as switching positions, or working with your doctor to troubleshoot relief options.

Irritable bowel syndrome (IBS)

You may not see it as a related issue, but IBS can, unfortunately, wreak havoc on your sex life by causing pain and discomfort during intercourse, says Dr. McGuirk. Treatment depends on your symptoms and triggers, but you can work with a gastroenterologist to adjust your diet and lifestyle habits accordingly. Staying hydrated and taking probiotics may also help.

Interstitial cystitis

Interstitial cystitis is a chronic condition that causes bladder pressure, bladder pain, and pelvic pain during and after sex, says Dr. McGuirk. It’s part of a spectrum of diseases known as painful bladder syndrome, per the Mayo Clinic, and treatments vary from prescription medications to surgery, depending on the condition’s severity.

Pelvic inflammatory disease (PID)

“PID is an infection of the reproductive organs caused by bacteria,” says Dr. McGuirk, and usually manifests as pelvic pain, fever, chills, and vaginal discharge. “PID is often easily treated with antibiotics, but if it goes untreated, it can cause chronic pelvic pain, as well as infertility,” McGuirk adds.

If you don’t think any of these conditions apply to you, but are still experiencing unusual pain after getting it on, McGuirk recommends seeing a doctor. That’s especially the case if the pain comes with other symptoms like abnormal bleeding, funky discharge, or a fever.

Kayla Blanton is a freelance writer who reports on all things health and nutrition for Men’s Health, Women’s Health, and Prevention. Her hobbies include perpetual coffee sipping and pretending to be a Chopped contestant while cooking.

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