Cramping After Sex? Here’s What Your Body’s Trying to Tell You

"Dyspareunia" is the medical term for any kind of pain during or after sex. But cramping after sex isn't always a big deal. If it's mild and occasional, it can be normal and not a cause for concern," says Kenosha Gleaton, MD, a board-certified OB/GYN and Everlywell medical advisor. On the other hand, severe or lasting pain is definitely a red flag that could signal an underlying problem.

To get a handle on what you might be dealing with, keep reading. Here's a look at some of the things that can give you cramps after sex and when it's a good idea to loop in your doctor.

1. It's a post-orgasm thing

The muscles in your pelvic region contract involuntarily from peak stimulation during sex, resulting in an orgasm. It feels good (obviously), but it can also cause some brief discomfort after the fact. "An orgasm creates uterine contractions, which can lead to cramping that should go away on its own within a few minutes," Dr. Gleaton says.

How to treat it

Cramping from an orgasm should be light and fade pretty quickly. For extra relief, a hot water bottle or heating pad can help, the Mayo Clinic recommends.

2. It's a sign of ovulation, period, or pregnancy

You might be more likely to notice post-orgasm cramping when you're ovulating or during your period. According to Dr. Gleaton, "Sex puts pressure on your uterus and cervix, which may already be sensitive during menstruation, ovulation, or pregnancy."

How to treat it

Here's another time where a heating pad or hot water bottle can be your BFF. You can also bump things up with an over-the-counter pain reliever like ibuprofen or sodium naproxen (Aleve), which can also help for cramping when you're ovulating or on your period, per the Mayo Clinic. You shouldn't take ibuprofen or sodium naproxen when you're pregnant, but acetaminophen (Tylenol) is usually okay. Just get the thumbs up from your OB/GYN first.

3. You're dealing with vaginal dryness

A drop in the hormone estrogen, which hits during perimenopause, causes your vaginal tissue to become thinner and drier, which can make penetrative sex painful, per the Cleveland Clinic. And when you anticipate discomfort, it's harder to fully relax your pelvic muscles, which can potentially lead to cramping, Dr. Gleaton explains. Major domino effect, people.

How to treat it

Vaginal lubricants (which you apply before sex) and vaginal moisturizers like Womaness Coco Bliss (which you apply daily, like a facial moisturizer) can help hydrate your tissues and make sex more comfortable, per the Cleveland Clinic. For more relief, your doctor may recommend hormone therapy like vaginal estrogen.

4. You had rough sex

Very deep penetration, which often happens with positions like doggy style or any position where your knees are up by your chest, can make you more prone to cramping. "They will put extra pressure on your uterus, cervix, and pelvis, especially if you're pregnant, menstruating, or ovulating," Dr. Gleaton says.

How to treat it

If a certain position causes discomfort, switch it up. Try going on top so you can control how deep things go, says Amir Marashi, MD, a New York City-based OB/GYN and founder and CEO of Cerē. Standard missionary (i.e., with your legs straight, not bent or up) or side-lying positions are good, too, because they tend to penetrate less deeply.

5. You've got a bladder infection

Urinary tract infections (UTIs) and interstitial cystitis (a type of chronic bladder inflammation that makes you have to pee nonstop) can both make you cramp up after sex. When you're already dealing with inflammation down there, any extra pressure (like from sex) can cause discomfort, Dr. Gleaton explains. "When you have sex, you’re putting extra pressure on your inflamed uterus or cervix, which can lead to cramping," she says.

Round-the-clock pelvic pain (including during sex) paired with nonstop peeing and urgency could be a sign of interstitial cystitis, a chronic condition where bladder inflammation messes with your normal gotta-pee signals, per the Mayo Clinic. As a result, you feel like you need to pee pretty much all the time.

How to treat it

See your doctor if you're having to pee more often than usual. They'll usually prescribe antibiotics for a UTI. If you have interstitial cystitis, your doctor might recommend a combination of pelvic floor therapy and medications (like antidepressants or antihistamines) that can reduce your urge to pee, says the Mayo Clinic.

6. It's an STI or other infection

Inflammation from STIs like chlamydia or gonorrhea, or other infections like a yeast infection or bacterial vaginosis, can all make you cramp up when sex puts extra pressure on your uterus or cervix, Dr. Gleaton explains. You'll know that's probably what you're dealing with if you're also having itching, burning, or changes to your usual vaginal discharge, according to the American College of Obstetricians and Gynecologists (ACOG).

How to treat it

Call your doc if you think you have a vaginal infection brewing. Antibiotics are usually a must, and starting meds sooner will help you feel better faster, notes ACOG.

7. You've got pelvic inflammatory disease

When an STI goes untreated, it can potentially morph into pelvic inflammatory disease or PID. Basically, it's severe inflammation around your cervix that makes sex crampy, not to mention causes a bunch of other problems. Think ongoing lower abdominal pain, a fever, foul-smelling discharge, or irregular periods, according to the Office on Women's Health.

How to treat it

Again, you gotta get on antibiotics to fix this, so call your doctor if you're having possible symptoms. Untreated PID can get worse if you ignore it and potentially lead to infertility, ectopic pregnancy, or chronic pelvic pain, the Office on Women's Health says.

8. It's a uterine fibroid

Fibroids are growths that can form on the inner or outer lining of your uterus (or within the muscle of your uterus wall), which sounds scary, but they're almost always benign. They can be annoying, though, because they can sometimes cause lower back, pelvic, or abdominal pain during sex, not to mention make your periods heavy and uncomfortable, per the Office on Women's Health.

How to treat it

It comes down to how big the fibroid is and the symptoms it's causing. Your doctor can prescribe hormonal meds to shrink small ones that are only mildly uncomfortable. Surgery might be needed for bigger ones, especially if they hurt, the Office on Women's Health notes.

9. You have an ovarian cyst

Fluid-filled sacs or cysts can sometimes form on your ovaries. They're not usually anything to worry about from a health perspective, but they can cause one-sided abdominal pain (including during sex), along with bloating, notes the Mayo Clinic. On rare occasions, cysts can also burst and cause severe pelvic pain and bleeding.

How to treat it

Sometimes cysts clear up on their own. If yours doesn't, your doc might recommend hormonal meds to prevent future ones from forming, or surgery for bigger ones. Seek medical attention if you have sudden or severe pelvic pain, pain with fever or vomiting, or weakness or lightheadedness, the Mayo Clinic recommends. These symptoms could mean your cyst has ruptured or burst.

10. You've got a tilted uterus

Ever heard of a retroverted uterus? Around 1 in 4 people with uteruses have one, meaning their uterus is tipped backwards toward the rectum rather than forwards toward the abdomen, notes the Cleveland Clinic. It's totally normal, but it can mean your uterus experiences more pressure during sex. That could lead to cramping or discomfort, especially with deeper penetrative positions, says Rebecca Keith, MD, a board-certified OB/GYN with Pediatrix Medical Group in Elizabethtown, Kentucky.

How to treat it

Experimenting with different positions should help. If positions like doggy style or missionary with your legs up make you crampy, try coming on top so you can control how deep things go, Dr. Keith recommends. Other good options: Lay side by side and have your partner enter you from behind, or try missionary with your legs lowered down.

11. It's a sign of endometriosis or adenomyosis

Endometriosis, a disorder where tissue similar to the lining of the uterus grows outside of the uterus, is known for causing a deep, aching pain during sex, especially around your period or with deeper positions, Dr. Marashi says. But for some people, the sensation might read as crampy. Endo can also make your periods super painful and heavy, and cause painful bowel movements and trouble getting pregnant, per the Mayo Clinic.

Adenomyosis—a condition that causes uterine lining to grow into the muscular wall of the uterus—is also notorious for causing cramps after sex, per Johns Hopkins Medicine.

How to treat it

Let your doctor know if you have symptoms that sound like endometriosis. Your doctor can prescribe hormonal meds like birth control pills, which can help manage your pelvic pain and heavy periods. In some cases, surgery might also be needed, the Mayo Clinic notes.

Causes of cramping after sex for males

It's far less common, but people assigned male at birth can potentially get pain or cramping after sex too. Often it's from an infection like herpes, gonorrhea, or even a yeast infection, per the Cleveland Clinic. In some cases, it could even be from constipation. But penile deformities, foreskin damage, or priapism (a condition marked by painful erections) can also be to blame.

Your primary care doctor or a urologist can pinpoint the underlying cause and recommend treatment.

How to treat cramps after sex

The fix for after-sex cramps depends on what's causing it. Some possible options include:

• Lie on your back and take some deep breaths: Both encourage your abdominal muscles to relax, which can ease mild cramping, Dr. Gleaton says.
• Heating pad or hot water bottle: Drape one over your lower abdomen for a few minutes. The heat helps your muscles relax, which should relieve your cramping, Dr. Gleaton says.
• OTC pain meds: NSAID pain-relievers like ibuprofen and sodium naproxen can offer more relief if heat alone isn't helping, per the Mayo Clinic. Again, don't take these meds if you're pregnant.
• Antibiotics: They're the go-to treatment for clearing up cramps caused by infections, Dr. Gleaton notes.
• Hormonal medication: Hormonal birth control and other options can often be used to manage cramping caused by endometriosis, fibroids, or a cyst.
• Surgical procedures: Your doctor might recommend surgery if hormonal medications aren't doing enough to manage a problem like endometriosis, fibroids, or a cyst.

Can you prevent cramps after sex?

You've got lots of options for keeping the cramps from coming back. You can:

• Switch positions. Get on top so you can control how deep your partner goes, Dr. Marashi suggests. Or try standard mission or a side-lying position. They penetrate less deeply, so they're not as likely to cause cramping.
• Manage underlying conditions. Sometimes brief, mild cramping is just from a powerful orgasm or because you're getting close to your period. But if the cramping stems from an underlying condition, addressing it is the best way to make sex more comfortable again. Schedule an appointment with your OB/GYN so you can discuss your symptoms.

When to see a doctor

It's worth seeking medical attention if you're getting post-sex cramps on the reg, if at-home measures aren't helping you feel better, or if the cramps are accompanied by other symptoms like bleeding, Dr. Gleaton recommends. All are signs that you've got something brewing health-wise that needs to be addressed.

FAQ

Why do my ovaries hurt after sex?

There's a pretty wide range of things that can cause lower abdominal or pelvic pain during or after sex. If the problem persists, the best way to figure out what you're dealing with is to see your doctor. You can talk over your symptoms together to figure out the culprit and decide on a treatment plan.

Does cramping after sex mean implantation?

Cramping after sex can be an indicator of early pregnancy, Dr. Gleaton says. When a fertilized egg attaches to your uterine wall (around 10 to 14 days after conception, per the Mayo Clinic), "you will often experience cramps that feel like menstrual cramps. Having sex only intensifies these cramps and makes them more noticeable," Dr. Gleaton says.

What does implantation feel like?

Implantation—when a fertilized egg attaches to your uterine wall—can sometimes cause brief, period-like cramps that intensify during sex, Dr. Gleaton says. You might also notice mild spotting for a day or two.

—reviewed by Andrea Braden, MD, OB/GYN