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Bloating and pain after sexual intercourse are not normal, and warrant medical attention. What could be causing these symptoms besides pregnancy?

Do you often suffer from pain, abdominal bloating and pressure, or both, after sex? If these symptoms are a frequent occurrence, you can’t blame them on one-off “too passionate” sex! What could be wrong with you? Your first thought may be that you could be pregnant, but if a pregnancy test and a period have already told you otherwise, it’s time to look elsewhere.

What can cause abdominal bloating and pain after sexual intercourse (dyspareunia) — other than pregnancy? Let’s examine that further.

Cervicitis: An Inflamed Cervix

Cervicitis is an inflamed or swollen cervix. Caused by sexually transmitted diseases (gonorrhea, chlamydia, herpes simplex, trichomoniasis, HPV) or exposure to physical objects or chemicals (spermicides, pessaries, an allergic reaction to latex condoms), cervicitis frequently shows up after sex.

Cervicitis can cause painful sexual intercourse, pelvic pain, and a feeling of pressure or bloating, along with abnormal vaginal bleeding and discharge. [1]

Ovarian Cysts

Ovarian cysts — fluid-filled sacs in or on an ovary — come in rather a few different kinds. While some are genuinely harmful, most aren’t, and will resolve on their own given time. They can cause some nasty symptoms, though!

Any woman who experiences abdominal bloating, pressure, and pain is right to suspect that she may be dealing with an ovarian cyst. Such cysts are so common that most women will have at least one during their lifetime, though they may not even be aware. [2]

Ovarian Cancer

Experiencing abdominal pain and bloating after intercourse may immediately lead you to suspect the worst, so it’s important to point out that roughly 16.23 in 100,000 women develop ovarian cancer [3]. This is not the first thing you should suspect!

Symptoms tend not to show up until the cancer is quite advanced, and they include:

  • Abdominal and back pain
  • Abdominal or pelvic pressure and bloating
  • Unexplained weight loss or gain, sometimes accompanied by a loss of appetite
  • Abnormal vaginal bleeding and alterations in your menstrual cycle
  • Gas
  • Nausea and vomiting [4]

Uterine Abnormalities

One in four women have a so-called retroverted uterus, in which the top of the uterus points towards the rectum rather than the abdomen. This doesn’t usually cause any issues, but it can sometimes lead to painful sexual intercourse, especially in certain positions (woman on top can be especially painful) and abnormally painful menstrual periods. [5]

Similar problems can arise in women with other uterine abnormalities, like uterus didelphys (a double uterus) [6] and a bicornuate (heart-shaped) uterus [7]. Some uterine abnormalities additionally lead to problems during pregnancy, so being aware of them before you try to get pregnant is always a good thing. 

Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) is a widespread infection of the female reproductive organs; the uterus, fallopian tubes, and ovaries. Usually but not always the result of untreated sexually transmitted diseases, PID leads to scarring and damage of the organs it attacks.

This causes symptoms such as:

  • Pelvic pain during sex and urination
  • Abnormal vaginal bleeding
  • Fever
  • Infertility (due to blocked tubes) [8]

Pelvic inflammatory disease can remain symptomless for a very long time, but it’s important to be treated as soon as possible — the longer it rages, the more damage it can do. In the early stages, antibiotics will clear it up.

Endometriosis

Endometriosis, a condition in which uterine tissue (the endometrium) also invades other areas of the reproductive system and even beyond, is another possible cause of pelvic bloating and pain, including pain after sex. Heavy and painful periods and bleeding between periods are other common symptoms. [9]

PCOS

Polycystic Ovary Syndrome is an endocrine disorder that leads to the overproduction of androgens. Its name may be deceptive, as the characteristic features of PCOS stretch far beyond polycystic ovaries alone — PCOS patients have altered metabolisms, often suffer from insulin resistance, may struggle with infertility, and are often obese. [10]

While its better-known symptoms include irregular periods, excessive hair growth, and weight gain, pain during or after sexual intercourse can also be a symptom of PCOS [11].

The Bottom Line

Abdominal pain and bloating after sexual intercourse are neither nice nor normal. It is impossible to self-diagnose the problem online, but even if you could, all the conditions that can cause these symptoms still need medical attention. As you’ve seen, some of the possible causes of pain and bloating after sex — like pelvic inflammatory disease, ovarian cancer, and reproductive system disorders — are rather serious. Some are much more easily treatable if they are diagnosed early on. Even less serious problems, like cervicitis because a certain spermicide doesn’t agree with you, may well require a doctor’s help to get to the bottom of what exactly is causing the problem.

Any woman who recognizes herself in these symptoms should see a gynecologist ASAP for proper diagnosis and, where necessary, treatment.

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