Post-Ejaculation Lower Abdominal Discomfort: Causes and Solutions

After ejaculation, there may be a feeling of dull pain or pressure in the lower abdomen (the suprapubic area) near the bladder?

Hello Doctor, I am currently 27 years old.
In recent years, I have noticed that if I ejaculate without having fully emptied my bladder beforehand, I experience a sensation in my lower abdomen that is difficult to describe—it's a feeling of pressure, fullness, and pain.
Sometimes this sensation lasts for 1 to 2 hours, while other times it resolves quickly, but it is very uncomfortable.
However, there are times when this does not occur, although the instances of discomfort are more frequent than not, and I am unsure if this is coincidental.
I have also observed that this sensation seems to occur more often when my penis is positioned upwards during ejaculation.
Could this posture be causing incomplete ejaculation and leading to retrograde ejaculation? This issue has been deeply troubling me, and I maintain good hygiene and do not engage in sexual activity or masturbation frequently.
I would appreciate your guidance on this matter.
Thank you.

Awei, 20~29 year old female. Ask Date: 2020/12/18

Dr. Xu Wencang reply Urology

It may be chronic pelvic pain, which can be evaluated and treated in an outpatient setting.

Reply Date: 2020/12/18

More Info

Post-ejaculation lower abdominal discomfort can be a perplexing issue, particularly when it occurs consistently after sexual activity or masturbation. Given your age and the nature of the symptoms you've described, there are several potential causes and considerations to explore.

Possible Causes
1. Prostatitis: Inflammation of the prostate gland can lead to discomfort during or after ejaculation. This condition can be acute or chronic and may present with symptoms such as pelvic pain, discomfort during urination, and pain during or after ejaculation.

2. Pelvic Floor Dysfunction: The pelvic floor muscles play a crucial role in sexual function and ejaculation. If these muscles are tense or dysfunctional, they may contribute to discomfort after ejaculation. This can be exacerbated by certain positions during sexual activity, such as the one you mentioned (with the penis pointing upwards).

3. Urinary Tract Issues: If you have not fully emptied your bladder before ejaculation, residual urine may contribute to discomfort. This can lead to a sensation of fullness or pressure in the lower abdomen.

4. Ejaculatory Duct Obstruction: This is a less common cause but can occur if there is a blockage in the ducts that transport semen. This can lead to pain or discomfort during or after ejaculation.

5. Psychological Factors: Anxiety or stress related to sexual performance or experiences can manifest physically, leading to discomfort.

Recommendations
1. Hydration and Urination: Ensure that you are adequately hydrated and urinate before engaging in sexual activity. This may help alleviate some of the discomfort you are experiencing.

2. Positioning: Experiment with different sexual positions to see if certain positions exacerbate or alleviate your symptoms. If you notice a pattern, it may be worth discussing with a healthcare provider.

3. Pelvic Floor Exercises: Consider pelvic floor exercises (Kegel exercises) to strengthen the pelvic muscles. This can help improve muscle control and potentially reduce discomfort.

4. Consult a Healthcare Provider: Given the recurring nature of your symptoms, it would be prudent to consult a urologist or a healthcare provider specializing in sexual health. They may recommend further evaluation, such as a physical examination, urine tests, or imaging studies, to rule out any underlying conditions.

5. Avoid Irritants: Pay attention to any potential irritants in your diet or lifestyle that may exacerbate your symptoms. This includes caffeine, alcohol, and spicy foods.

6. Stress Management: If you suspect that anxiety or stress may be contributing to your symptoms, consider stress management techniques such as mindfulness, meditation, or counseling.

Conclusion
While post-ejaculation discomfort can be distressing, understanding the potential causes and taking proactive steps can help manage your symptoms. It is essential to maintain open communication with your healthcare provider to ensure that any underlying conditions are addressed appropriately. Remember, you are not alone in experiencing these symptoms, and seeking help is a positive step towards finding relief.

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