Post-Sexual Activity Pain: When to Seek Medical Advice

Low back pain and lower abdominal pain one week after sexual intercourse?

Hello Doctor: On March 24-25, I had genital friction with my partner; I was wearing pants, but my partner was not.
On March 30, I had sexual intercourse for the first time, with one instance of unprotected external ejaculation (on my buttocks) and another instance with a condom throughout.
On March 31, I started experiencing lower abdominal discomfort (similar to menstrual cramps) that has persisted until now.
It is tolerable.
Starting April 4, I occasionally feel dizzy and nauseous.
On April 6, I woke up with soreness in my lower back, thighs, and near my buttocks, and these symptoms have continued intermittently.
My expected menstrual period was supposed to start on April 6, but so far, there are no signs of it coming, so I would like to inquire about what might be happening.
Should I see a doctor or take a pregnancy test? Additionally, I would like to ask if I need to have a Pap smear if I have only had sexual intercourse once.
If I do not engage in sexual activity again, is it still necessary? Thank you for your help.

L, 20~29 year old female. Ask Date: 2023/04/07

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the probability of pregnancy should be low, so observation is sufficient.
If you have had sexual experience, you may consider getting a Pap smear, which is a simple and convenient test.
Wishing you good health.

Reply Date: 2023/04/07

More Info

Understanding post-sexual activity pain can be complex, especially when accompanied by other symptoms such as abdominal discomfort, dizziness, and nausea. Based on the timeline and symptoms you've described, it is crucial to consider several potential causes and when to seek medical advice.

Firstly, the abdominal pain you are experiencing could be related to various factors. Given that you mentioned the pain is similar to menstrual cramps, it could be linked to ovulation or hormonal changes, especially if your expected menstrual period is delayed. Stress, anxiety, and changes in routine can also affect your menstrual cycle, leading to missed periods or altered symptoms. However, if the pain persists or worsens, it is essential to consult a healthcare provider to rule out any underlying conditions.

The dizziness and nausea you mentioned could be attributed to several factors, including hormonal fluctuations, anxiety, or even dehydration. If these symptoms are severe or accompanied by other concerning signs, such as heavy bleeding or severe pain, it is advisable to seek medical attention promptly.

Regarding your question about pregnancy, if you have engaged in unprotected sexual activity, even if it was a single instance, there is a possibility of pregnancy. If your period is late, taking a home pregnancy test can provide clarity. If the test is positive, or if you continue to experience symptoms without a clear explanation, it is essential to consult a healthcare provider for further evaluation.

As for the question of whether you need a Pap smear after only one instance of sexual activity, the general recommendation is that individuals with a cervix should begin cervical cancer screening at age 21, regardless of sexual history. This means that even if you have only had one sexual encounter, it is still advisable to have regular screenings as part of your preventive healthcare. The frequency of these screenings will depend on your age and health history, so discussing this with your healthcare provider is important.

In summary, while some discomfort after sexual activity can be normal, especially if it is your first experience, persistent or severe symptoms warrant medical evaluation. It is always better to err on the side of caution when it comes to your health. If you are experiencing significant discomfort, changes in your menstrual cycle, or other concerning symptoms, please seek medical advice. Your healthcare provider can offer personalized guidance, perform necessary tests, and help you understand your symptoms better.

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