Why Do I Get a Stomachache After Sex?

Walking side-to-side may seem like a sexual feat to Ariana Grande, but for me, hobbling home with a sore stomach is not the post-sex feeling I'm chasing after. And this type of pain is much more than a little achiness after aggressive thrusting, something typically attributed to a lack of lubrication or pulling a muscle. Right after orgasm, I curl up in a ball and wait for the intense throbbing to pass. It feels similar to menstrual cramps, lasting up to two hours along the lower region of my abdomen and up toward my belly button.

It wasn't until recently that, while twisting in bed feeling frustrated, I decided to dive into WTF was going on with my gut (and beyond). I took to Instagram to ask my community if they've ever felt anything similar—22 people responded with a resounding, "Yes!"

One person, Macy, 28, an artist in New Jersey, said they usually get stomachaches after orgasm whether through masturbation or penetrative sex, although it doesn't happen every time. Macy's libido has recently evaporated as well, although they aren't sure if it's linked to their pain. "It feels like a menstrual cramp but, honestly, worse in some ways because instead of just hurting, it also makes me a little nauseous as well," she explained. After 15 minutes, Macy said, the pain subsides, "but those moments feel like forever."

Approximately 10 minutes after orgasm, North Carolina resident Lina, 30, said she experiences a stomachache. Like Macy (and me), it doesn't happen every time she has sex and she's noticed it with different partners—that's right, dick size doesn't matter. "I just recently started tracking my cycle with the pain to see if there is any correlation," she explained, but so far she hasn't noticed anything substantial other than a link to orgasms. Lina, who has polycystic ovarian syndrome (PCOS), a hormonal disorder that causes cysts, has always assumed the two were linked but has never visited a doctor about the correlation.

"Pain after sex is not normal," said Heather Jeffcoat, D.P.T., a California-based pelvic therapy expert and author of "Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve." Jeffcoat said when she sees patients with this type of issue, there is "either pelvic floor, hip or low back muscle overactivity or connective tissue restrictions to blame."

While it's difficult to diagnose, there could be a few reasons—beyond a lack of lube—for what's causing stomachaches after climax.

Fibroids

Uterine fibroids, noncancerous uterine tumors, grow in or on a uterus and can result in heavier and longer periods and abdominal pain that occurs outside of sex. Though the cause is unknown, these growths are typically diagnosed during an ultrasound or MRI. Fibroids can cause the womb to tilt backward (something that simply occurs naturally in other people), which causes discomfort in the stomach during sex since the penis hits the cervix more directly. Regulating nutrition and hormonal therapy can help shrink fibroids.

Retroverted uterus

When the uterus is tipped backward, aiming toward the rectum instead of the front of the belly, this is something called a tilted or retroverted uterus. A quarter of women have a retroverted uterus, which is something some are born with, while others develop it later in life, according to a 2021 paper published in StatPearls. Conditions like endometriosis and pelvic inflammatory disease (PID) can pull the uterus out of its natural shape and result in retroversion. During sex, a penis may hit the cervix, making some positions more sensitive than others and result in a deep, throbbing pain in the abdomen.

Pelvic inflammatory disease (PID)

Chlamydia or gonorrhea, especially if untreated, may cause PID, an infection in the reproductive system that can lead to scarring and infertility. Symptoms of PID range from mild to severe pelvic pain, discomfort during intercourse, fever, painful urination or abnormal bleeding (like spotting or irregular periods). After insertion of an IUD, there is a small increase in the risk of PID within the first three weeks of insertion, according to a 2014 study in the Indian Journal of Medical Research. PID discomfort after sex may feel like a pain deeper in the pelvic area. It's usually treated with antibiotics for two weeks.

Ovarian cysts

An aching sensation around your lower right or left side, where your ovaries are located, could be ovarian cysts. If the cysts are large (bigger than about 4 inches), abdominal pain and cramping after sex may occur. An ultrasound can discover if you have a cyst; patients usually have to wait for it to go away on its own (cysts typically disappear after two to three months).

Pain after sex can be alarming

If there are signs of an infection (like a grayish-white or yellow discharge or a foul odor), Jeffcoat advises that patients visit their OB-GYN or general doctor. Using a moist heat pack on the low back of the abdomen and taking slow deep breaths can help with the pain short-term, she explained. If the discomfort continues, she said, "make sure to get medically cleared for organic causes of pain and consider seeking an assessment by a skilled pelvic floor physical therapist."

It can be tough to deal with discomfort after all of the feel-good sensations during intercourse or a solo session. If it isn't a hurts-so-good type of pain, a professional can help you get to the bottom of your postcoital aches.