Picture this: You and your partner are finally getting in some sexy time (or you’re having a solo session) when all of a sudden, you feel an intense pain that can only be described as a stabbing feeling up inside your vagina. What gives? You don’t have your period, you’re not ovulating, and you don’t typically have pain during sex. Turns out, it’s quite possible that some rough sex caused you to bruise your cervix—the narrow, lower part of the uterus.

A “bruised cervix” refers to an injury to that part of your reproductive system, though the name itself isn’t entirely accurate. “When you think of a bruise, you see this visible, bluish mark after some kind of hit or trauma,” Rebecca Keith, MD, a board-certified OB/GYN with Pediatrix Medical Group in Elizabethtown, Kentucky, tells Well+Good. “The cervix doesn’t necessarily bruise, but it can become irritated, which can cause pain.”

According to Dr. Keith, this type of injury is pretty rare; in fact, she’s never actually seen one in her 30 years of medical practice. But she knows cervix irritation can be uncomfortable—causing cramping and sharp pelvic, abdominal, or lower back pain that can last anywhere from a few hours to a few days.

Not sure if this has happened to you? Read on to find out the possible causes, and ways to treat a bruised cervix if you find yourself in pain after a particularly rough romp in the sack.

How does a bruised cervix happen?

Virtually all cervical bruises happen from penetrative sex. “Because the cervix sits deep inside the vagina, it’s generally pretty well protected,” Dr. Keith says.

But certain positions or hard thrusting could cause a penis or another object to penetrate deeper than usual and potentially hit the bottom of the cervix. “Since the cervix has nerve endings, it’ll send out a signal of sharp pain or discomfort,” says Dr. Keith.

Who’s more at risk for cervix bruising?

Again, cervix injuries are pretty rare. But according to Dr. Keith, certain things can make them more likely. These factors can include the following:

• Deep penetrative positions: The doggy-style sex position is the most likely offender, Dr. Keith says. Missionary with your legs up or reverse cowgirl (you on top, facing away) can be pretty deep, too.
• Anatomical differences: About 25 percent of people with a uterus have something called a tilted or retroverted uterus—which means the organ is tipped backward towards the rectum instead of forward towards the abdomen. This positioning could make it easier for a penis or another object to hit your cervix during sex, Dr. Keith says. Anatomically, it’s completely harmless and normal, she adds.
• Uterine prolapse: Uterine prolapse happens when a person’s pelvic floor muscles become weak and unable to support their uterus, causing both the uterus and cervix to slip down into the vagina. This can make it easier for your cervix to get injured during penetrative sex. The condition is more common in people who’ve had one or more vaginal births or who have gone through menopause.
• Cervix infection: Any kind of infection or inflammation in the cervix can make the area more sensitive, potentially setting the stage for painful sex. Infections can stem from things like bacteria, yeast, or from a sexually transmitted infection (STI).
• Lack of arousal: As you become more “turned on” during sex, your cervix will pull further up and away from the opening of the vagina—leaving more room for things like a penis or other penetrative object. If you begin to have penetrative sex before this happens (think: before you’re fully aroused), you might up the odds for an injury, Dr. Keith adds.

Is treatment necessary for a bruised cervix?

Thankfully, treatment is not often necessary for a bruised cervix injury. “This is something that usually goes away in a day or two on its own,” Dr. Keith says. That said if your injury stems from an underlying issue—like a cervix infection or uterine prolapse—addressing the root cause by visiting your healthcare provider will not only make sex more comfortable but help you avoid re-injuring yourself.

The best thing to do in the meantime? If you notice cervix pain (or any pain) during sex, stop right away and refrain from certain sexual activities until your symptoms have gone away. Don’t put anything else in your vagina either, including tampons. “The most powerful treatment is just pelvic rest,” Dr. Keith adds.

If you’re still in discomfort, try at-home remedies like draping a heating pad over your lower abdomen or gently massaging that area. You can also take over-the-counter pain relievers like Motrin, Aleve, or even Midol to help ease cramping, says Dr. Keith.

3 tips to prevent a bruised cervix

If you’ve had a bruised cervix in the past, there are a few things you can do to prevent it from happening again in the future. Here’s what Dr. Keith recommends:

• Switch up your sex positions: If you’re having sex with a partner, try positions that will avoid or limit deep penetration. For example, try lowering your legs if you’re in missionary, lying side-to-side while your partner penetrates you from behind, or coming on top so you can control how deep things get. If you’re using a sex toy, opt for items that won’t go as deep.
• Save plenty of time for foreplay: To avoid feeling any irritation or dryness while doing the deed, make sure you’re turned on by allowing for plenty of foreplay time. Communicate to your partner what you want and need, and make sure you’re both fully prepped for intercourse.
• Address underlying conditions: If sex hurts often or you’re having other symptoms (like pelvic pain when not having sex, unusual vaginal discharge, or trouble peeing or pooping), these could be signs you have an underlying health problem that needs to be treated—like a cervix infection or uterine prolapse. If you think this might be the case, schedule an appointment to see a healthcare provider.

When to see a healthcare provider

If you experience mild pelvic or cervix pain one time during sex, it likely isn’t cause for concern—especially if it goes away shortly after. But if sex is often (or always) painful, the discomfort lasts several days, or you are bleeding after intercourse (that’s not from menstruation), it’s best to let your healthcare provider know, Dr. Keith says. They can run tests to make sure you don’t have an infection or other health condition, and provide proper treatment to relieve your symptoms.

FAQ

Can a bruised cervix affect fertility?

A bruised cervix itself won’t impact your ability to get pregnant, Dr. Keith says. But an underlying condition like cervicitis (aka a cervical infection) could affect your fertility if it isn’t treated. So seek medical care if you’re having frequent pain during sex or other cervicitis symptoms like abnormal vaginal discharge, unusual spotting, or irritation around your vagina or vulva.

What are the signs of a damaged cervix?

If you injured your cervix during sex, you might experience sharp pelvic pain or abdominal or lower back discomfort that lasts anywhere from a few minutes to a few days, Dr. Keith says. The problem typically clears up after a day or two with pelvic rest—i.e., refraining from sexual activity.

Should I be worried about a bruised cervix?

According to Dr. Keith, there’s no need to be worried about a bruised cervix. While it can be painful, it is pretty rare, so you don’t need to stress too much about getting one, she adds. That said, there are a ton of other things that can potentially make sex hurt, including vaginal infections, endometriosis (a condition where endometrial tissue grows outside of the uterus), or vaginal dryness—all of which are worth addressing. So if you’re experiencing pain, always let your healthcare provider know.