If you get pain during sex or after sex once in a while, it’s usually no big deal. Maybe you just went a little rougher than usual, are too dry, or are about to get your period and are a little more sensitive “down there.” You may feel this pain in your vulva, pelvis, or even back. But what does it mean if you have stomach pain after sex if you’re female (or have a vagina)?

“If the pain occurs just once and doesn’t recur, it may not be a cause for concern. Sometimes, it could be due to rough sex, a partner of a different size, an upset stomach, or even injuries related to sex, says Amir Marashi, MD, a New York City-based OB/GYN and founder and CEO of Cerē. But other times, it might mean you have an underlying gynecologic or GI issue that needs to be addressed.

Here are ten possible reasons why you have stomach pain after sex if you have a vagina, when to see your doctor about it, and how to prevent it from coming back.

10 reasons for stomach pain after sex if you have a vagina

There are many reasons why someone might feel stomach pain after sex if they have female reproductive organs, like a vagina. This can range from gynecologic issues to GI issues and may also depend on the location of the pain.

1. Endometriosis

Endometriosis—a disorder where tissue similar to the lining of the uterus grows outside of the uterus—is one of the most common causes of painful sex, according to Dr. Marashi. That’s especially true “if the pain occurs during deep penetration positions like the knee-chest or “doggy style positions,”” he adds.

The condition can also cause very painful or heavy periods, painful bowel movements, and trouble getting pregnant, per the Mayo Clinic. Sometimes, endometriosis can come with gut health issues that make it difficult to distinguish between uterus cramps after sex or a GI condition.

How to treat it

See your doctor if you think you could have endometriosis. Hormonal medications like birth control pills can often help manage your endometriosis pain and heavy periods. In some cases, surgery might also be needed, the Mayo Clinic notes.

2. Vaginal dryness

Dry vaginal tissue, which often hits during perimenopause or menopause as estrogen levels decline, can cause irritation that makes sex uncomfortable or painful. You might also get itching, burning, or even spotting during or after sex, too, per Mount Sinai.

How to treat it

Many people find relief by using a vaginal lubricant (applied before sex) and a vaginal moisturizer (applied daily, like a facial moisturizer), which hydrates dry tissues to make sex more comfortable, Dr. Marashi says. Topical estrogen (applied as a cream, ring, or tablet) can also help ease more severe symptoms, per Mount Sinai.

3. Vaginismus

When you have vaginismus, your vaginal muscles may involuntary tense or spasm during penetrative sex or gynecologic exams, which can cause pain. (In some cases, it can make it impossible to have penetrative sex.) It often happens in people with a history of sexual trauma or abuse, or in people who have an abnormal response to physical pain, according to the National Library of Medicine (NLM).

How to treat it

Treating vaginismus involves therapies that make you less sensitive to penetration. That could include pelvic floor exercises, physical therapy, counseling, and sex therapy exercises like vaginal dilation, per the NLM.

4. Uterine fibroids

Fibroids—benign growths that form on the lining of the wall of the uterus—are known for causing heavy or painful periods and a feeling of fullness in your lower abdomen. But they can also cause lower back pain, pelvic, or abdominal pain during sex, per the Office on Women’s Health.

How to treat it

Fibroid treatment depends on how big the fibroid is and the symptoms it’s causing. Small fibroids that cause discomfort can sometimes be managed with hormonal medications like birth control pills or gonadotropin releasing hormone agonists. Larger ones may need to be removed surgically, according to the Office on Women’s Health.

5. Ovarian cysts

Cysts, or fluid-filled sacs, that form on your ovaries are usually harmless. But they can cause intermittent abdominal pain (including during sex) that’s concentrated on one side, bloating, and a feeling of pressure or fullness in your abdomen, per the Mayo Clinic. In rare instances, a cyst can burst and cause severe pain and pelvic bleeding.

It’s also possible to have multiple cysts on each ovary, a condition called polycystic ovary syndrome (PCOS). This condition often comes with other symptoms like weight gain, extra body or facial hair, or irregular periods, per Johns Hopkins Medicine.

How to treat it

Some cysts will clear up on their own; others can be shrunk with hormonal medications or removed with surgery. You should seek emergency medical attention if you have sudden or severe pelvic pain, pain with fever or vomiting, or weakness or lightheadedness, per the Mayo Clinic. These could be signs the cyst has ruptured or burst.

6. Infections

Vaginal infections like yeast infections, urinary tract infections (UTIs), or sexually transmitted infections (STIs) can all cause pelvic pain or discomfort, including during sex. The infections are usually accompanied by a change in your usual vaginal discharge—think a different amount or consistency, color, or odor, per the American College of Obstetricians and Gynecologists (ACOG).

How to treat it

Vaginal infections usually require medication, so let your doctor know if you think you have one. Depending on the infection, they may prescribe an antibiotic like metronidazole or clindamycin, ACOG says. If you get repeat yeast infections, your gynecologist might recommend managing them with an over-the-counter (OTC) med like miconazole. But don’t self-treat your yeast infection without your doctor’s okay.

7. Pelvic floor dysfunction

Pelvic floor dysfunction, where your pelvic floor muscles aren’t able to relax and coordinate actions like peeing and pooping, can cause pain in your pelvis, rectum, or lower back. The pain can be ongoing (including during sex) or be more noticeable when you’re trying to poop, per the NLM. You might also have to strain to pee or poop or deal with incontinence.

How to treat it

Pelvic floor dysfunction may be relieved with pelvic floor therapy. Your therapist can help you figure out where you’re tensing your muscles and show you exercises to stretch and coordinate them. They may even recommend post-sex stretching to help relax your pelvic floor.

8. Pelvic inflammatory disease

Pelvic inflammatory disease (PID), which often stems from an untreated STI like gonorrhea or chlamydia, “causes inflammation around the cervix, leading to pain during intercourse,” or while urinating, Dr. Marashi says. You might also have ongoing lower abdominal pain, a fever, foul-smelling discharge, or irregular periods, according to the Office on Women’s Health.

How to treat it

Antibiotics are needed to clear up PID. So if you’re having possible symptoms, let your doctor know. The infection can get worse if you ignore it and can potentially lead to complications like infertility, ectopic pregnancy, or chronic pelvic pain, per the Office on Women’s Health.

9. Vulvodynia

If you’re plagued by recurring sharp or raw pain, irritation, or burning around your vulva (the outer part of your genitals), with no clear cause, you could have vulvodynia. This condition typically lasts about three months and has no clear cause. Many people with vulvodynia find it difficult to have sex because it hurts too much, according to the Mayo Clinic. And if they do have sex, it can make the pain worse.

How to treat it

A multi-pronged approach usually works best. Your doctor might recommend pain medications (like antidepressants, local anesthetics, or nerve blocks), pelvic floor therapy, cognitive behavioral therapy, or sex therapy, depending on your symptoms and treatment goals, the Mayo Clinic notes.

10. GI issues

If you have any stomach or GI issues going on, penetrative sex can definitely make it feel worse. “Issues related to the gastrointestinal system, such as constipation, diarrhea, or bloating, can all contribute to abdominal pain during or after sex,” Dr. Marashi says. These can also all be symptoms of GI conditions like IBS, inflammatory bowel disease (IBD), or food intolerances.

How to treat it

The fix depends on what’s causing your symptoms. You can usually ease constipation and bloating (which can come with constipation) by drinking more water, eating more fiber, and getting more movement, per the Mayo Clinic. But if you’re dealing with diarrhea? Stick with a bland diet and drink plenty of water until your symptoms ease up. If your symptoms aren’t resolved after a few days, or you’re in pain, reach out to your doctor to rule out any underlying GI conditions.

How to get rid of stomach pain after sex

Relieving abdominal pain after sex will depend on addressing the underlying cause, Dr. Marashi says. In the meantime, here are some steps to help soothe any discomfort:

• Apply heat. A warm compress, heating pad, or hot water bottle draped over your lower abdomen can help ease stomach cramps after sex by reducing muscle spasms, notes Johns Hopkins Medicine.
• Try an OTC pain reliever. Options like ibuprofen, naproxen, or acetaminophen can all give you quick relief if you have lower abdominal pain after being sexually active.
• Prescription medications. Antibiotics can help clear up infections, while birth control pills and other hormone-based therapies might be needed for problems like endometriosis, fibroids, or cysts. You and your doctor can talk about your options and decide on a fix.

Preventing stomach pain after sex

Again, preventing cramps after sex will depend on pinpointing and treating the underlying cause, Dr. Marashi says. Depending on the problem, your options might include the following:

• Change positions. Switching it up can make a big difference for certain conditions. “For instance, endometriosis patients may feel pain when the penis reaches very deep and hits the area of uterosacral nerve behind the uterus. In such cases, switching to positions like side-lying or missionary can help reduce discomfort,” Dr. Marashi explains. Getting on top might help, too, because it gives you more control over the depth of penetration, he adds.
• Vaginal moisturizers and lubricants to hydrate dry vaginal tissue and reduce painful friction.
• Pelvic floor therapy to stretch and strengthen your pelvic muscles. Your therapist might even recommend using a vibrator at home. “Vibration increases blood flow to the pelvic floor muscles and the clitoris, which can help rehabilitate the muscles over time,” Dr. Marashi explains. This may reduce your chances of being sore after sex.

When to see the doctor

There are a number of different reasons why your stomach would hurt after sex. Let your doctor know if your pain keeps coming back—whether it happens during sex or not. The same goes for pain that’s continuous, severe, or accompanied by other symptoms like period changes or unusual vaginal discharge, says Dr. Marashi. “Persistent or repetitive pain can indicate an underlying issue that needs to be addressed,” he adds.

FAQ

Does stomach pain after sex mean you are pregnant?

Stomach pain after sex doesn’t necessarily mean you’re pregnant. Most often, the cause of this pain is from something harmless like constipation or bloating, or it could be a chronic condition like endometriosis or fibroids. The best way to figure out what you’re dealing with? See your doctor, especially if the pain is bad or if it keeps coming back, Dr. Marashi recommends. And if there’s a chance you could be pregnant, taking an at-home pregnancy test is always a good step.

Why do I feel sick after sex?

Deep pelvic or abdominal pain that happens when you have sex can sometimes give you a sick-to-your-stomach feeling. But the pain can have a ton of different possible causes. If you’re not sure what you’re dealing with, it’s best to get checked out by a doctor.

Can deep sex hurt your stomach?

Yes. You’re more prone to it if you have a condition like endometriosis, Dr. Marashi says. But sometimes rough sex or deep positions can cause one-off pain, he adds. If it hurts or doesn’t feel right, stop and try something different next time!

—reviewed by Andrea Braden, MD, OB/GYN