Why Does It Hurt After I Come?

We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions will remain anonymous. Please send your questions to tips@bustle.com. This week’s topic: causes of post-orgasm pain.

Q: Sometimes during sex, I get intense painful cramps right after I come. It’s awkward because I have to stop having sex immediately, but also it's extremely painful. It feels like something’s really really wrong, and sometimes it takes a while to go away. Sometimes it even starts right as I’m nearing orgasm, which let me tell you is super confusing for my body and brain. I’m starting to get freaked out about sex, because I never know when it will end up causing me more pain than pleasure. Any idea what’s going on, or what I can do to stop this?

A: It sounds like you are talking about the condition dysorgasmia, which is just the fancy medical term for pain during or after orgasm. Dysorgasmia can be caused by a bunch of different underlying causes, and is characterized by feelings of pain in your abdomen or pelvic area right after orgasm — or sometimes even during. This can be a horrible situation to deal with, because sex is supposed to feel good. That’s, like, it’s primary purpose (other than the whole baby-making thing). So it’s a good idea to figure out what is causing this, so you don’t have to deal with it any longer!

Here are the potential causes for post-orgasm cramping or pain — and what you can do about them.

You Could Just Have Muscle Cramps

You probably think of cramps as associated with menstruation, but you can also get cramps post-orgasm. Orgasming actually causes your vagina and the muscles in your pelvis to contract, which is a lot of what makes it feel so good! However, as with any muscle working hard, you might end up with a muscle cramp after orgasm. These cramps might go away quickly, but can last up to a few hours.

If this is the reason for your post-orgasm pain, the good news is that you probably know how to sooth your pelvic muscles from dealing with regular period cramps. Heat, anti-inflammatory pain killers, medical marijuana if you live in a place that has legalized it — these can all help the cramps subside.

Your Cervix Might Have Been Touched During Sex

The cervix is a pretty tender part of the body, and if it’s touched during sex, it can cause the surrounding muscles to contract and cramp. If your sex romp involved deep penetration, it is totally likely that your cervix getting hit is the reason for your cramps.

Also, some people have tilted or tipped uteruses, which is just a description of how their uterus is placed in their bodies, specifically vis-a-vis their vaginal canals. This uterus placement makes it easier for an inserted penis, toy, or hand to hit the cervix. Luckily, there are so many positions to try out that don’t hit the cervix — consider this a health reason to pick up a copy of the Kama Sutra!

You Could Have Uterine Fibroids

Uterine fibroids are very common, and are one of the main reasons why people have cramps after sex. These are benign, non-cancerous tumors that show up on your uterus. In addition to causing pain after sex, they can cause heavy bleeding when you’re on your period, and spotting between periods. So if this sounds like you, talk to your doctor. While fibroids aren’t dangerous, you can get them removed surgically if they are causing you pain.

You Could Have Ovarian Cysts

It’s also possible that you could have one or more cysts on your ovaries, which is the other most common reason for post-orgasm pain. Ovarian cysts are small sacs filled with fluid. Most people with ovaries will get a cyst or few sometime in their lives, with no issues. In most cases, cysts go away on their own without treatment. However, sometimes they rupture, which is very painful.

Some people who have cysts experience pain after sex — specifically, on the side where they have the cyst. So if your cramps after sex are localized to just one side, chances are you might have a cyst. If the cyst is painful or your doctor thinks there’s a chance it will rupture, you may want to get it surgically removed.

You Could Have Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID), is exactly what it sounds like — inflammation of your pelvic area. This situation most often occurs from chlamydia or gonorrhea infection, two sexually transmitted bacterial infections, although it can be caused by any bacterial infection of the pelvic region. In some people, PID can cause pain during sex because everything is just inflamed and tender up there. However, many people don’t experience any symptoms. Luckily, if you find out you do have PID, you can get it cleared up by treating the bacterial infection that’s causing it.

You Could Have Endometriosis

Endometriosis is a medical condition where some of your uterine lining cells (also called the endometrium) grow outside your uterus. Each month, these cells thicken and bleed along with the rest of the endometrium to give you your period — but outside the uterus, the blood has no place to go. The result is irritated tissue that develops into painful scar tissue or adhesions. People with endometriosis often experience significantly painful periods, but they can also feel pain after sex.

It is unfortunately not easy to know if you have endometriosis. You have to undergo exploratory surgery so your doctor can verify that you have wayward uterine lining cells in other parts of your body. However, your gynecologist can make a pretty good guess based on your pain levels of cramps, when you get your cramps and for how long, and by ruling out other reasons for pelvic pain.

You Could Be Reacting To Specific Medications

Some recent research suggests that people on certain medications are more likely to experience pain after sex. These include some antidepressants (Anafranil, Prozac, Paxil, Zoloft, Effexor) and some antipsychotics (Haldol, Serentil). Far more research needs to be done to corroborate this research and figure out just why this is happening. But if you are on these medications and you are experiencing pain after sex, talk to your doctor.

You Could Be Pregnant

If you are in the first stages of pregnancy, it’s actually pretty common to feel pain after sex. If this happens to you and you are pregnant, definitely let your doctor know.

The Bottom Line

Orgasms are designed to make you feel good, but it can be hard to appreciate them if we’re worried that they will be followed by intense cramping and pain. If this is happening to you, talk to your doctor to figure out why, so you can go back to fully enjoying the deliciousness that is sex!