12 Things That Cause Abdominal Pain And Cramping After Sex, Explained by Experts

We often talk about the pleasure that sex gives us—how good it feels and how relaxing it can be; however, we don’t talk much about sex-related pain. Women’s sexual pain is underreported, so it can be difficult to estimate how many suffer from post-sex abdominal pain and cramping. But medical experts reassure us about two things:

1. You’re not alone.
2. There’s usually a way to determine the cause and treat it.

The causes of post-sex cramping and pain can often differ from the things that cause pain during sex, says Lauren Streicher, MD, medical director of Northwestern Medicine’s Center for Sexual Medicine, clinical professor of obstetrics and gynecology at Northwestern University’s medical school, the Feinberg School of Medicine, and author of Sex Rx: Hormones, Health, and Your Best Sex Ever. Still, they can sometimes be related.

We asked medical experts to explain some of the reasons people may experience abdominal pain and cramping after sex and what to do about it.

Causes of cramping after sex for women

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Cramping after sex once in a while usually isn’t cause for concern. For instance, cramping could linger from a big orgasm or rough sex, or even pop up post-intercourse because you’re coming up to your period.

But if pain or cramping after sex is a regular occurrence, that’s not normal—and it could signify an underlying condition that needs attention. Below, our expert gynecologists and recent research explain what can cause discomfort after sex, what to do about it, and when you should seek treatment. 

1. Orgasms and deep penetration

During an orgasm, the muscles in the pelvic floor—the muscles that support the pelvic organs, including the uterus, bladder, and rectum—tense up and then release. “That release is part of the pleasurable feeling of an orgasm,” says Dr. Streicher.

But just like any other muscle, these areas can cramp up and not fully release, which can cause a dull cramping sensation after sex.

The uterus can also cramp up if it’s being hit repeatedly, says Susan S. Khalil, MD, director of sexual health at Mount Sinai Health System and assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine.

Often, it’s positional: Certain positions, like doggie style or woman on top, can lead to deeper penetration than normal, hitting the uterus in a way that’s a bit uncomfortable and causes it to tense up and cramp, says Dr. Khalil.

2. Menstruation

As if you need another reason to be annoyed by your monthly period, it could cause you to be more prone to abdominal cramping after sex.

“Some women are more sensitive during different points in their menstrual cycle, specifically leading up to it,” says Dr. Khalil. Extra poking and prodding and pressure in sensitive areas can leave you feeling crampy for a bit afterward.

In this case, you’d be able to notice a monthly trend for when you experience post-sex cramping and pain.

3. Ovulation

Not on your period, but still experiencing cramping or pain after sex? If you’re tracking your menstrual cycle and are midway through, this discomfort might be due to ovulation.

“Mittelschmerz,” or lower abdominal pain during ovulation, is relatively common—and like cramps during menstruation, sex may cause a flare-up. But ovulation causes other changes that may contribute to discomfort after sex, too. 

“After the egg is released from the ovary (when a woman ovulates), sometimes that area where the egg was housed can leak a little bit of fluid, or it can swell with some blood,” explains Margaret Sullivan, MD, an Obstetrician and Gynecologist at Tufts Medical Center. “We call that a corpus luteal cyst, or a hemorrhagic corpus luteal cyst, and that can irritate the surrounding uterus and ovaries, causing discomfort around ovulation.” 

While pain and cramping after sex during your ovulation phase isn’t usually a cause for concern, if it’s a monthly occurrence, it’s worth getting checked out by an OGBYN. “I wouldn’t necessarily say it’s normal if you’re forming recurrent cysts, and that’s why you’re having pain,” Dr. Sullivan explains. “There are definitely management options to prevent cysts from those types of cysts from coming and causing symptoms.”

In some cases, a cyst might rupture during sex, too. “If you have a sudden onset of pain with intercourse that doesn’t get better, then you should seek medical attention.” 

4. Bowel issues

Bowel issues like irritable bowel syndrome (IBS) or Crohn’s disease can also cause post-sex cramping, says Dr. Streicher. This is more so because chronic bowel issues can impact the function of the pelvic floor muscles over time, leading to tensing and cramping that doesn’t fully release when it’s supposed to.

These gastrointestinal conditions also cause inflammation near the pelvic area, especially during flare-ups—and the added pressure from intercourse can cause extra discomfort. 

For some people, though, something as simple as severe constipation can make them tense up during sex and experience abdominal cramping afterward, she says. If that’s the case, treating and clearing out the constipation could resolve the issue and get rid of any sex-related discomfort.

If you have IBS or Crohn’s and experience pain after sex, Dr. Sullivan advises consulting your gastroenterologist to evaluate what’s going on and determine management strategies specific to how your condition is affecting your sex life. 

But in general, 2025 research published in Current Gastroenterology Reports says that for people with inflammatory bowel diseases (IBD), some approaches to reduce or prevent pain from occurring after sex can include:

• Using lubricants, topical or estrogen therapy, or estrogen replacement therapy to address vaginal dryness, which is common among women with IBD. 
• Trying different positions (or tools like a sex pillow) that minimize discomfort. 
• Using silicone rings to reduce pain with deeper penetration. 
• Pelvic floor physical therapy.
• Planned bowel and bladder emptying prior to sexual intercourse.

Delmaine Donson/Getty Images

5. Pelvic floor dysfunction

“For 90% of women who have pain during and after sex, pelvic floor dysfunction is [a part] of it,” Dr. Streicher says. “What happens is that initially, you may have pain for some other reason, and it very quickly will turn into a pelvic floor dysfunction.”

When sex is uncomfortable or painful, the muscles in and around your vagina react and tense up, basically to stop you from having sex. Over time, the muscles learn to stay tense and don’t release as they should. “They are in protective mode, and we have to re-educate those muscles and teach them that you are going to have something in your vagina and it’s not going to hurt,” she says.

There are a lot of things that can cause discomfort and ultimately lead to pelvic floor dysfunction—from dryness to stress to a more serious medical problem. A lot of things may not start out as a pelvic floor problem but eventually turn into one, Dr. Streicher notes.

The good news is that, since it’s a learned problem, it can be unlearned with pelvic floor physical therapy, she says. (And, of course, figuring out what caused the pain in the first place.)

6. Uterine fibroids and ovarian cysts

Sometimes, post-sex cramping can be caused by uterine fibroids or ovarian cysts, says Dr. Khalil.

Fibroids are benign growths in the uterus that are common and often asymptomatic. Many women with fibroids never know they have them. But when they are symptomatic, they can cause pelvic pressure or pain and constipation, both of which can lead to uncomfortable post-sex cramping.

Cysts are fluid-filled sacs that grow in or on the surface of the ovaries. Like fibroids, cysts are common and often don’t cause any symptoms or problems, but an especially large cyst can cause pelvic pain and fullness or heaviness in the abdomen.

If you have symptoms of uterine fibroids or ovarian cysts, it’s important to check in with your OB-GYN. You don’t have to tolerate the discomfort: there are a range of treatment approaches available depending on the severity, ranging from monitoring to medication and surgical procedures. 

7. Endometriosis

If you feel pain every time or most times you have sex, it may be a sign of a medical issue that needs attention.

Endometriosis is a condition where tissue that is similar to the type lining the uterus starts to grow in other places in the pelvic area, says Dr. Khalil, who runs a pelvic pain clinic. “Sometimes it infiltrates the nerve supply in the pelvis or the ovaries, and with movement, it triggers a painful cycle,” she says. “For some women, it’s sharp pain; for some, a dull, aching sensation.”

Endometriosis could be anywhere in the pelvic area, but it’s primarily in the lower abdomen, and some patients have it on one side or the other, says Dr. Khalil. Some people may even have this tissue growing on their colon or bladder.

If you’re experiencing signs of endometriosis, make an appointment with your OB-GYN, Dr. Sullivan says. “It’s really important to have the proper diagnosis,” Dr. Sullivan says. “Sometimes we can suspect a patient has endometriosis, but the only way to tell for sure is to do a surgical procedure called a laparoscopy, and we put a little camera into the umbilicus, and we take a look—and that’s done on general anesthesia.”

8. Past trauma

Sometimes, pelvic pain after sex can be completely unrelated to the physical act and more due to the result of past sexual trauma.

Trauma presents in many delayed forms, Dr. Khalil notes, and many people may not connect that current sexual discomfort is related to something that happened in the past. It may happen only in certain situations that are triggering, or it may happen every day and be debilitating, she says.

If there’s a psychological basis for sex-related pain, your gynecologist can be a great starting point and help you find psychological support and care when it’s warranted.

9. Anxiety

When experiencing stress or anxiety, it’s common for people to clench their jaw, tense up their shoulders, or experience other muscle aches throughout their body. This same stress and anxiety-induced tension can occur in your pelvic muscles, according to 2024 research published in BMC Women’s Health. 

This means that after sex, your pelvic muscles—already a bit spent by the intercourse itself—might stay tensed up, causing pain and cramping. Plus, anxiety tends to worsen our perception of pain, per the research. 

Generally, treating anxiety through lifestyle changes, stress management techniques, and with the support of a mental health professional can alleviate this pain after sex. But if it persists—even with psychological care—it’s important to get evaluated by your doctor for other possible causes.

10. Sexually transmitted infections

Sexually transmitted infections (STIs) can cause a constellation of symptoms, including pelvic pain, Dr. Sullivan says. This pain is not necessarily specific to just after sex, but intercourse can aggravate pelvic pain and inflammation. 

According to 2024 research published in StatPearls, chlamydia is known to cause lower pelvic pain, increased sensitivity of the cervix, and tenderness in the tissues and organs near the uterus—all of which can contribute to pain and cramping during or after sex. Gonorrhea can also cause cervical inflammation and lower pelvic pain, and trichomoniasis is associated with pain during or after sex. 

If left untreated, chlamydia and gonorrhea can cause pelvic inflammatory disease (PID), a serious condition that can cause permanent damage to your reproductive organs. Pelvic and lower abdominal pain, including during or after sex, are common symptoms. While PID can result from other types of vaginal bacteria, these untreated STIs are the most common cause, per the Cleveland Clinic. 

Untreated STIs can lead to other complications that contribute to pain and cramping during or after sex as well. “If an STI migrates to the upper part of the uterus and causes an infection in the fallopian tube, that can cause swelling—or sometimes, something called a TOA (tubo-ovarian abscess),” Dr. Sullivan says. “But that’s usually more of a significant infection that a patient’s had for quite a while.” 

11. Pregnancy

According to a 2022 article published in the Journal of Midwifery & Women’s Health, having an orgasm while pregnant can trigger uterine contractions. Semen also contains hormone-like substances called prostaglandins, which can contribute to cramp-like contractions after sex. 

The research says that it’s not generally a cause for concern—but if your cramping doesn’t go away within one or two hours or gets stronger, contact your healthcare provider.

Dr. Sullivan adds that if the baby’s head is positioned very low on the pelvis, this could cause some discomfort or cramping during or after sex. It’s not a common complaint, she says, but if you’re experiencing significant discomfort or other unusual symptoms, contact your healthcare provider.

12. Myofascial pain syndrome

Myofascial pain syndrome is a chronic condition that triggers pains, aches, cramps, soreness, and other uncomfortable symptoms due to inflammation in your muscles and connective tissue (fascia). When it comes to issues like cramping after sex, this is a condition that’s often overlooked, Dr. Sullivan says.

“In the pelvis, there are many different organs—we’ve got the bladder, the uterus, the rectum, the cervix, and the vagina,” she explains. “These organs are lined by certain pelvic muscles, and sometimes those muscles can get very irritated and tight.”

She says that the treatment for myofascial pain syndrome is pelvic floor therapy, where a skilled physical therapist can go in and do internal physical therapy, helping to release the tightness in the pelvic muscles causing this type of pain.

Causes of cramping after sex for men

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Men can experience pain and cramping after sex as well, explains Justin Houman, MD, FACS, of Tower Urology at Cedars-Sinai Medical Center. Like with women, pelvic floor muscle tension or spasm is one of the more common causes. “Overactive pelvic floor muscles can lead to post-coital pain, particularly if there is chronic pelvic pain syndrome or myofascial dysfunction,” he explains.

Prostatitis is another common cause of pain after sex in men. “Inflammation of the prostate, often due to bacterial infection [but can occur from nonbacterial causes], can lead to discomfort after ejaculation, which may radiate to the lower abdomen.”

Dr. Houman says that other potential reasons men have pain or cramping after sex include:

• Bladder irritation or cystitis: An inflamed or irritated bladder can cause cramping, particularly if there is post-ejaculatory urinary urgency or pain.
• Epididymitis: Inflammation of the epididymis (a tube attached to each of the testicles) can cause referred pain in the lower abdomen, particularly after ejaculation. 
• Hernias: Whether caused by a sports injury or muscle weakness, increased intra-abdominal pressure during sexual activity can exacerbate pain related to an undiagnosed or existing hernia.
• Irritable bowel syndrome (IBS): Gastrointestinal issues, particularly in men with IBS, can be aggravated by abdominal muscle contractions and pelvic floor engagement during sex.
• Referred pain from kidney stones: If a stone is present in the ureter (the tube that carries urine from the kidney to the bladder), sexual activity may exacerbate lower abdominal pain.
• Testicular issues (varicocele, hydrocele, or torsion): Testicular problems can sometimes cause referred pain in the lower abdomen or groin.
• Post-orgasmic pain syndrome (POPS): A rare condition where men experience discomfort or cramping in the lower abdomen or perineum after orgasm.
• Post-surgical or scar tissue pain: Men with a history of pelvic or abdominal surgery (such as hernia repairs, vasectomy, or prostate surgery) may experience adhesions or nerve irritation that leads to post-coital discomfort.

None of these issues are considered normal, and it’s important to get checked out by your medical provider or a urologist if you’re experiencing pain or cramping after sex.

In particular, Dr. Houman says to see a doctor if you have a history of hernia or abdominal surgery, or if you experience:

• Severe, persistent, or worsening discomfort.
• Pain accompanied by urinary symptoms. 
• Swelling or pain in the testicles. 
• Pain radiating to the flank (the side area between your lower ribs and hips) or back.
• Fever or flu-like symptoms, such as chills, fatigue, or body aches.
  

Can an IUD cause cramping after sex?

An IUD is a small, T-shaped device that’s implanted into the uterus for pregnancy prevention. When inserted, irritation to the cervix and uterus can trigger contractions—so it’s relatively common for women to experience cramping for a few weeks. (Though some women may have mild cramping that gradually decreases for up to six months after insertion.) 

Because sex can add more stress to the uterine area, including the cervix, these cramps can feel more intense afterward. But again, any discomfort should reduce over time and go away completely within a few months, max. 

Past this initial post-insertion phase, “an IUD that’s positioned correctly should not cause pain after sex,” Dr. Sullivan says. “There’s always a small risk that an IUD can sort of migrate into the wall of the uterus or into a position where it wasn’t initially placed, and that can certainly cause discomfort.”

In other cases, an IUD can move lower into the uterus, approaching the cervix, and that can cause discomfort, too, she says. “If you have new onset pain with an IUD in place, that requires an evaluation, an exam, and sometimes an ultrasound to assess the location of the IUD.” 

Does vaginismus cause cramping after sex?

“Vaginismus is an involuntary response, a tightening of the pelvic floor that can cause a lot of pain with any type of insertion, whether that’s intercourse or tampons,” Dr. Sullivan explains. “The way I explain it to patients is it’s like touching a hot stove—it’s a reflex, and your muscles in the perineum (the muscles around the vagina) tighten up and sometimes prohibit anything from inserting into the vagina.”

So, vaginismus isn’t generally associated with pain or cramping after sex but during penetration. However, 2021 research published in Sexual and Relationship Therapy explains that spasming of the vaginal muscles after intercourse is attempted could result in residual cramping. 

How to ease pain and cramping after sex

“Over-the-counter remedies can be quite helpful,” Dr. Sullivan says. “We prefer something in the Motrin and ibuprofen category, like NSAIDs (non-steroidal anti-inflammatory drugs such as Advil or naproxen)—they tend to target the uterine musculature better than things like Tylenol.” 

She usually advises patients to take 600 milligrams of Motrin as needed to relieve pain or cramping after sex—and a warm heating pad can be soothing as well. “That should give you some temporary alleviation of your symptoms, but you should definitely see your gynecologist for a thorough evaluation [if it’s a recurring problem].” 

How to prevent cramping after sex

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There’s no one-size-fits-all solution to prevent pain or cramping after sex, Dr. Sullivan says. “There are so many different entities that can lead to pelvic pain in general.”

In some cases—like if you’re having rough period cramps this month or are sensitive to deeper penetration—using lubrication, making time for plenty of foreplay to “warm up,” and trying out different positions to see what’s most comfortable can help prevent cramping after sex. 

Or, if you have issues with your pelvic floor muscles, physical therapy and techniques like Kegel exercises can strengthen these muscles, promoting better blood flow to your pelvic muscles and relaxing spasms that cause post-sex discomfort. As pelvic floor dysfunction can contribute to other health issues, it’s best to seek professional care and follow a regimen customized to you.

Still, if you’re regularly experiencing pain and cramping after sex, Dr. Sullivan says it’s important to get an evaluation to isolate what the issue is. This might entail physical pelvic imaging—like an ultrasound or MRI—or a surgical laparoscopy to identify the problem and tailor the right treatments.

When to see a doctor for pain and cramping after sex

Both Dr. Streicher and Dr. Khalil say that generally, if you experience abdominal cramps and pain after sex every once in a blue moon, it’s not something to worry about. Using a heating pad and taking NSAIDs like ibuprofen or naproxen may help ease the discomfort.

But if it happens more times than not, you feel a sharp pain during or after sex, and/or your symptoms last longer than a couple of hours, you should see a doctor to figure out what’s going on. Regular or persistent post-sex abdominal cramping and pain is usually a sign that something’s off, and your doctor can help you sort it out and figure out the cause so that you can properly treat it and be able to enjoy sex without worrying about that nagging discomfort.

However, see a doctor immediately if you experience sudden sharp abdominal pain, as it can be a sign of ovarian torsion, says Dr. Khalil. It’s rare, but it requires immediate medical attention.

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