Abdominal Soreness After Sex
Question: My partner and I have been engaging in penile/vaginal intercourse for several months and after sex I am sore in my lower abdominal region (usually the next morning the pain is the most prevalent). The soreness ranges from slightly uncomfortable to painful and can persist for several days. I’ve never had any bleeding nor have I had any problems with this with previous partners and I want to stress that the pain is not in my vagina but in my lower abdominal region. My current partner has a large penis (slightly under 9 inches) and I am of average size for a woman. During our last encounter, we had to end sex because of an unbearable splitting pain in my lower abdominal region where my pain usually occurs, and I had this pain for nearly five days. We’ve experimented with this dilemma and have discovered that we can both feel when his penis hits whatever it is that causes my pain. My question is what would his penis likely be hitting and are there any possible short-term or long-term problems that this may cause?
Answer: For both men and women, pain can occur in the pelvic area during or soon after sexual intercourse. It can happen at any time during sex -- for example, at the time of penetration, erection, or ejaculation. Eventually, if pain from intercourse is ongoing, you could lose interest in any sexual activity. The medical term for this is dyspareunia. Dyspareunia is pain that occurs only (or primarily) during sexual intercourse. It is not a disease, but rather a symptom of an underlying physical or psychological disorder. The pain, which can be mild or severe, may appear in the genitals, the pelvic region, or the lower back. The condition is much more common among women.
For women, causes include vaginismus, a psychological condition characterized by spasms of the vaginal muscles and insufficient vaginal lubrication; scars from an episiotomy (an incision made to facilitate childbirth); thinning and dryness of the vaginal wall due to estrogen deficiencies accompanying menopause, or breastfeeding; and inadequate foreplay.
Disorders that may cause pain upon deep vaginal penetration include:
Pelvic inflammatory disease
Ovarian cysts
Endometriosis
Varicose veins in the pelvis
Ectopic pregnancy
Other causes include:
Infections, such as sexually transmitted diseases, which may irritate the vaginal walls or the skin of the penis
Bladder or other urinary tract disorders such as cystitis or urethritis
Cancer in the sex organs or the pelvic region
Arthritis, especially in the lower back
Allergies to spermicides or to the latex in condoms and diaphragm
Symptoms include a burning, ripping, tearing, or aching sensation associated with penetration. The pain can be at the vaginal opening, deep in the pelvis, or anywhere between. It may also be felt throughout the entire pelvic area and the sexual organs and may occur only with deep thrusting.
Treatment is aimed at identifying and properly treating the underlying disorder.
Medications are prescribed to treat infections, if they exist. If an allergy to latex is suspected, alternative methods of contraception should be considered. If the spermicide is causing discomfort, try a different brand or consider using alternate methods of birth control.
A water-based lubricant may help ease discomfort and friction. However, avoid oil-based lubricants, such as petroleum jelly, since they dissolve the latex in condoms and may actually promote infection.
Insertion of a graduated set of dilators into the vagina may be used to treat vaginismus. Pain during intercourse due to an episiotomy generally subsides over time. Psychological counseling may be advised if no underlying physical abnormalities can be identified.
SPOT encourages you to make an appointment with SHS (737-WELL) and speak with a health care provider about your symptoms and concerns. Good questions to ask about Dyspareunia include: What is causing the pain? Is the condition allergy based? Would estrogens help? What is the best lubricant to use? Will counseling help? And, of course, any other questions you deem necessary and important.
— February 28, 2007