anonymous on August 30, 2011

Sometimes I get a very painful abdominal cramp during sex. What is it?

I’m a 23-year-old female and sometimes I get a painful cramp in my stomach during or after intercourse. It hurts so much I have to just sit down for 15-30 minutes. It doesn’t happen every time I have sex but it’s been going on for about a year...and only with my current partner. Any ideas what this could be?

answered by Annette Fuglsang Owens, MD, PhD on August 30, 2011

I’m sorry about the pain you’re experiencing, but I appreciate your sharing your concern with us.Pain with intercourse can be caused by a number of conditions, and only your regular doctor can diagnose the root cause of your symptoms. But I’m happy to offer you my best thoughts for your consideration.

One possible cause of abdominal pain and cramping is something calledendometriosis. During your period, the lining of your uterus thickens and is shed when you bleed. With endometriosis, “islands” of that same tissue that lines your uterus can grow on the outside of the uterus or on other places where it doesn’t belong…like your ovaries. That tissue also thickens and bleeds and – since it doesn’t have an easy way to leave the body – it can become trapped, which can cause pain.

Other times, activities like rough sex or having sex multiple times in a row can also cause deeper pain…but, from what you describe, it doesn’t sound like that’s the issue for you.

Another possible cause of abdominal pain ispelvic inflammatory disease (or PID).This can be caused by chlamydia, which is a very common sexually transmitted disease (STD)…or, less commonly, by gonorrhea.

With PID, the uterus and fallopian tubes can become inflamed and even damaged. So it’s important to get treatment, usually with antibiotics. While there often aren’t a lot of symptoms with PID – and many times women don’t know they have it – it can cause deep pain, which is an indication to see your doctor.

I’d also encourage your partner to get tested for STDs, since this could give you some clues, as well…for example, men can have chlamydia and not have any signs or symptoms of infection.

Or, you might havefibroids, which are non-cancerous (benign) tumors of the uterus. Fibroids are very common…and while many women have them, they often don’t know it and don’t experience any problems.

But fibroids can cause things like bleeding between periods, heavier bleeding during periods, or pain with sex. If you have fibroids, there are various treatment options depending on your situation, including lifestyle modifications, acupuncture, anti-inflammatory drugs, hormone therapy, birth control pills and even surgery.

Finally, ifyou haven’t already started seeing your doctor every year for a regular exam, including Pap and HPV tests as needed, I would encourage you to do so. Early detection is key to avoid potentially more serious complications down the road.

Thanks again for writing, and I hope your symptoms are soon resolved.

Related info:

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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