A lot of women complain about an unusual pain in their lower abdomen which occurs either during or after sex or in both cases. Any pain associated with sexual intercourse is marked as dyspareunia, but most of those painful events are affecting superficial sex organs - vulva and vagina, and are caused by infection, irritation, or injury. However, certain amount of women experience pain of different quality originating from their lower abdomen. Although the cause of this pain cannot always be found, there are several conditions that may produce this pain.
Cervivitis is an infection of cervix caused by bacteria, fungi, parasites, or viruses. This condition can cause painful sexual intercourse which can be followed by prolonged pain in lower abdomen after sex. It is especially painful if caused by Herpes simplex virus. Other than pain, the symptoms of cervicitis resemble changes in normal vaginal discharge, vaginal bleeding, frequent urination, and sometimes fever, depending on the microorganism that caused the infection.
Endometrium is the inner layer of uterus, and endometriosis is a condition in which different amounts of endometrial tissue are present outside of the uterus. Endometriosis can affect any organ in the body, but the endometrial tissue is most often displaced in the nearby organs, such as Fallopian tubes, ovaries, cervix, etc. Women with endometriosis experience lower abdominal pain during menstruation, but the pain also occurs during sexual intercourse, especially with deep penetration, and prolongs after the intercourse.
Large ovarian cysts can be the cause of lower abdominal pain during the intercourse. Namely, during the intercourse, especially in particular positions, the ovarian cysts can be injured, thus producing the pain which can continue after the intercourse. In all women with painful intercourse, the presence of ovarian cysts needs to be assessed.
Most women have the uterus tilted forwards, but in 20-30% of women, the uterus is tilted backwards which is called retroverted uterus. Even this is a normal variation, it can cause unwanted movements of uterus during the intercourse and more hurtful contact with surrounding organs which produces pain. Other position abnormalities of uterus can also cause disturbed kinetics of uterus and lower abdominal pain.
Fallopian Tubes Infection
Fallopian tubes infection is also called pelvic inflammatory disease and it is a common cause of lower abdominal pain related or unrelated to sexual activity. However, the pain is much worse during and after the intercourse.
The assessment and the establishment of right diagnosis is very important, not only because of the pain issues, but also because it can be the sign of a more serious disease.
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