Why Does Your Stomach Hurt After Sex? 13 Possible Causes

Have you ever experienced pain in your lower abdomen or pelvis after sexual intercourse? You’re not alone. Many people—especially women—report discomfort ranging from mild cramping to sharp, persistent pain following sex. Is this normal? Should you be concerned?

Today, we’ll explore 13 common causes of abdominal or pelvic pain after sex, helping you understand what might be happening—and when to seek medical advice.

Note: While many refer to this as “stomach pain,” the discomfort is typically located in the pelvic region—not the upper abdomen where the stomach resides. True abdominal pain occurs above the navel; pelvic pain is felt lower, near the uterus, ovaries, bladder, or rectum. In clinical terms, this is often called abdominal-pelvic pain.

Let’s examine the most frequent underlying causes.

1. Sexual Position and Deep Penetration

Certain positions—such as the missionary position or doggy style—can lead to deep penetration, which may cause pressure or impact on sensitive pelvic structures like the cervix, uterine ligaments, or bowel. This mechanical stimulation can result in post-coital discomfort.

Solution: Try positions that give you more control over depth and angle, such as:

• Woman-on-top (allows self-regulation of penetration)
• Spooning (gentle, shallow entry)
• Sitting or reclining positions

These options reduce forceful contact and allow for more comfortable intimacy.

2. Vaginal Dryness

Insufficient lubrication is a leading cause of post-sex pain in women. Dryness can lead to friction, micro-tears, and irritation during intercourse.

Common causes include:

• Hormonal changes (e.g., menopause, breastfeeding)
• Side effects of birth control pills
• Stress, anxiety, or depression
• Certain medications (e.g., antihistamines)

Solution: Use water-based or silicone-based personal lubricants. If dryness persists, consult a healthcare provider about hormonal therapies or other treatments.

3. Infection or Inflammation

Untreated vaginal infections—including yeast infections (candidiasis) or bacterial vaginosis—can become aggravated by sexual activity. Bacteria like Escherichia coli or fungi like Candida albicans can inflame vaginal tissues, making intercourse painful.

Symptoms often include:

• Burning or stinging sensation
• Unusual discharge
• Itching or redness
• Pain during or after sex

Important: Avoid sex until the infection clears. Continuing intercourse can worsen inflammation and delay healing.

4. Uterine Fibroids

Fibroids (also called leiomyomas) are non-cancerous growths in or around the uterus. They’re very common—especially among women of reproductive age.

While many fibroids cause no symptoms, larger or submucosal fibroids can press against surrounding organs or stretch pelvic ligaments. During sex, especially with deep penetration, this pressure can trigger:

• Dull or sharp pelvic pain
• Cramping
• A feeling of fullness or pressure

If fibroids are suspected, imaging (like ultrasound) can confirm their presence and guide treatment.

5. Endometriosis

Endometriosis occurs when tissue similar to the lining of the uterus (endometrium) grows outside the uterus—in the ovaries, fallopian tubes, bladder, bowel, or pelvic lining.

During menstruation, this tissue bleeds and triggers inflammation, scarring, and adhesions (sticky bands of tissue that bind organs together). These adhesions can pull on pelvic structures during intercourse, causing:

• Deep, stabbing pain during penetration
• Persistent ache after sex
• Pain during bowel movements or urination

Endometriosis is one of the most common causes of chronic pelvic pain and infertility. Diagnosis often requires laparoscopic surgery.

6. Ovarian or Pelvic Cysts

Ovarian cysts are fluid-filled sacs that form on or inside the ovary. Most are harmless and resolve on their own, but if a cyst is large, ruptures, or twists (ovarian torsion), it can cause significant pain—especially during or after sex.

Pelvic cysts may also press on nearby nerves or organs, creating discomfort during physical contact.

Warning signs: Sudden, severe pelvic pain, nausea, dizziness → Seek emergency care.

7. Tilted (Retroverted) Uterus

A tilted uterus—where the womb tips backward toward the spine—is completely normal and affects up to 30% of women. In some cases, it can cause discomfort during deep penetration because the penis may come into contact with the back wall of the vagina or cervix.

This isn’t dangerous—but changing positions (e.g., side-lying or woman-on-top) can help relieve pressure.

8. Minor Trauma or Micro-Injuries

Vaginal walls are delicate. Rough sex, inadequate arousal, or lack of lubrication can cause tiny tears, abrasions, or bruising—especially near the entrance or posterior fornix.

These minor injuries usually heal within hours to a day. However, if pain lasts longer than 24–48 hours or is accompanied by bleeding, see a doctor to rule out more serious issues.

9. Cervicitis

Cervicitis is inflammation of the cervix, often caused by:

• STIs: chlamydia, gonorrhea, herpes simplex virus (HSV)
• Non-infectious causes: chemical irritants (douches, spermicides), allergies

Symptoms include:

• Pelvic pain during/after sex
• Abnormal discharge
• Bleeding between periods or after intercourse
• Burning during urination

Herpes-related cervicitis tends to cause more intense, recurrent pain. Testing and treatment are essential to prevent complications.

10. Latex Allergy or Sensitivity

Some individuals have an allergic reaction to latex, the material used in many condoms. Symptoms may include:

• Burning or itching in the genital area
• Swelling
• Redness
• Pelvic or abdominal discomfort

Solution: Switch to non-latex condoms (polyurethane, polyisoprene, or lambskin). Also consider checking for sensitivity to spermicides or lubricants.

11. Cystitis (Bladder Infection)

Cystitis is a urinary tract infection (UTI) affecting the bladder, commonly caused by bacteria entering through the urethra. Sex can introduce bacteria into the urinary tract, triggering or worsening infection.

Symptoms include:

• Lower abdominal/pelvic pain
• Frequent, urgent need to urinate
• Burning during urination
• Cloudy or strong-smelling urine

Drink plenty of water, urinate after sex, and see a doctor if symptoms persist—antibiotics are often needed.

12. Anatomical Mismatch

Sometimes, pain arises simply due to differences in size or shape between partners’ genitals. For example, a larger penis or deeper vaginal vault may lead to unintended contact with sensitive areas like the cervix or pelvic floor muscles.

Solution: Communication and experimentation with positions can help find what feels best. Slower, gentler penetration often reduces discomfort.

This is rarely a medical problem—it’s mostly a matter of compatibility and technique.

13. Polycystic Ovary Syndrome (PCOS)

PCOS is a hormonal disorder characterized by:

• Irregular or absent periods
• High levels of androgens (“male” hormones)
• Multiple small cysts on the ovaries

While PCOS itself doesn’t directly cause pain, the associated ovarian cysts can become irritated or enlarged. During sex, movement or pressure may trigger discomfort—especially if follicles are fragile or inflamed.

Additionally, PCOS often coexists with pelvic inflammatory conditions, endometriosis, or chronic constipation—all of which can contribute to post-sex pain.

When to See a Doctor

Most post-sex discomfort is temporary and benign. But contact a healthcare provider if you experience:

• Pain lasting more than 48 hours
• Severe or worsening pain
• Bleeding outside of menstruation
• Fever, chills, or unusual discharge
• Pain during urination or bowel movements
• Difficulty becoming pregnant

These could signal infections, endometriosis, fibroids, or other treatable conditions.

Final Thoughts

Pain after sex is more common than you might think—but it shouldn’t be ignored. Whether it’s due to simple factors like position or dryness, or something more complex like endometriosis or infection, identifying the root cause is key to relief.

Don’t suffer in silence. Talk to your partner, track your symptoms, and consult a gynecologist or primary care provider. With proper diagnosis and care, you can enjoy satisfying, pain-free intimacy again.

✅ Pro Tip: Keep a symptom journal. Note when pain occurs, its intensity, what positions trigger it, and whether it’s linked to your menstrual cycle. This helps your doctor make a faster, more accurate diagnosis.