Pain During Intercourse: Causes and Prevention Tips

Dyspareunia

Hello, doctor.
I would like to ask you some questions.
Yesterday afternoon, I had sexual intercourse with my boyfriend.
We always shower and use the restroom before and after intercourse, and we use condoms every time.
This has never happened before.
At the beginning of the intercourse, there were no issues, but as the intensity increased, I started experiencing lower abdominal pain, so we immediately stopped.
I thought it might be due to my ovulation period and the intensity of the activity, but even after stopping, I still felt pain.
It wasn't severe enough to prevent me from walking, but when I went to the restroom, I didn't experience pain while urinating.
Warm water provided some relief.
I then went to a nearby gynecology clinic, but by the time I got there, the pain had diminished.
The doctor listened to my description and performed an internal examination, suggesting that it might be due to muscle contractions during intercourse and some inflammation, but she didn't specify what type of inflammation it was, nor did she conduct blood tests—only the internal exam.
She prescribed antibiotics and pain relievers.
Later in the evening, I had a bowel movement, which I thought might be due to the greasy food I had for lunch, as I've been experiencing diarrhea lately (though I'm not entirely sure).
In the evening, I began to feel slight pain when urinating, but there was no frequent urination or bleeding.
Strangely, after returning home, the lower abdominal pain disappeared, and there was no tenderness.
Therefore, I would like to ask if this could be pelvic inflammatory disease.
I have searched for a lot of information online, but my symptoms don't seem to match.
I have no abnormal discharge, fever, and I didn't experience pain after returning home, etc.
I have maintained good hygiene, and my partner has as well.
There was no pain at the beginning of intercourse; it just suddenly occurred.
I'm really confused about what could have caused this, as I have never experienced anything like this before.
I wonder if it could be related to my recent lack of sleep, combined with my tendency to be anxious.
I am mainly worried about the possibility of pelvic inflammatory disease because I read that it could lead to infertility, which concerns me.
However, the doctor didn't explicitly state this; she only mentioned inflammation.
The sudden lower abdominal pain during intercourse startled me.
I want to know if this is pelvic inflammatory disease or some other type of inflammation.
Also, given that I maintain good hygiene and have a steady partner, what could be the reason for the sudden abdominal pain during intercourse? How can I prevent this? I would appreciate your answers, doctor.

21 sui nvxing, 20~29 year old female. Ask Date: 2022/07/31

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it could be a mild bladder or pelvic inflammation.
Since there is no pain now, just drink plenty of water and monitor the situation.
It will not affect your future health.
Wishing you good health!

Reply Date: 2022/07/31

More Info

Experiencing pain during intercourse can be concerning and may arise from various causes. Based on your description, it seems that you experienced sudden lower abdominal pain during sexual activity, which subsided after stopping. You also mentioned that you had no unusual discharge, fever, or persistent pain afterward, which is reassuring. However, it is understandable to be worried about conditions like pelvic inflammatory disease (PID) or other infections.

Possible Causes of Pain During Intercourse
1. Muscle Contraction: As your doctor suggested, pain during intercourse can sometimes be attributed to involuntary muscle contractions in the pelvic area. This can happen due to anxiety, tension, or even excitement. When the muscles are tense, they may not relax properly during intercourse, leading to discomfort.

2. Ovulation Pain: Since you mentioned that you were in your ovulation period, it’s possible that you experienced mittelschmerz, which is a type of pain some women feel during ovulation. This pain is typically localized to one side of the lower abdomen and can be sharp or cramp-like.

3. Infection or Inflammation: While your doctor did not specify the type of inflammation, it is possible that you could have a mild infection or inflammation in the pelvic area. This could be due to various factors, including recent sexual activity, hormonal changes, or even gastrointestinal issues, especially since you mentioned experiencing diarrhea.

4. Gastrointestinal Issues: Given that you had a recent episode of diarrhea, it’s also worth considering that gastrointestinal discomfort could be contributing to your abdominal pain. Sometimes, bowel issues can cause referred pain in the pelvic region, which may feel similar to pain originating from reproductive organs.

Prevention and Management Tips
1. Relaxation Techniques: Since anxiety and tension can exacerbate muscle contractions, practicing relaxation techniques before and during intercourse may help. This could include deep breathing exercises, gentle stretching, or even engaging in foreplay to help both partners feel more comfortable.

2. Communication with Your Partner: Open communication with your partner about comfort levels, pressure, and pace during intercourse can help prevent discomfort. If something feels painful, it’s important to stop and discuss it.

3. Hydration and Diet: Maintaining a balanced diet and staying hydrated can help prevent gastrointestinal issues. If you notice that certain foods trigger discomfort, it may be beneficial to avoid them.

4. Regular Check-ups: Since you have concerns about potential infections or pelvic inflammatory disease, it’s advisable to have regular gynecological check-ups. If symptoms persist or worsen, further evaluation, including blood tests or imaging, may be warranted.

5. Avoiding Irritants: If you are prone to urinary discomfort, consider avoiding irritants such as caffeine, alcohol, and spicy foods, which can exacerbate bladder sensitivity.

6. Post-Intercourse Care: After sexual activity, it’s a good practice to urinate to help flush out any bacteria that may have entered the urethra. This can help prevent urinary tract infections (UTIs), which can cause pain during urination.

When to Seek Further Medical Attention
If you experience persistent pain, unusual discharge, fever, or any other concerning symptoms, it is crucial to seek medical attention. While your current symptoms may not indicate a serious condition, it’s always better to err on the side of caution, especially regarding reproductive health.

In summary, while your experience of pain during intercourse can be alarming, it may not necessarily indicate a severe underlying issue. By addressing potential causes, practicing preventive measures, and maintaining open communication with your healthcare provider, you can better manage and understand your symptoms. If you have ongoing concerns, don’t hesitate to follow up with your gynecologist for further evaluation and peace of mind.

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