By Nicole Guappone

So you and your partner are getting it on and it feels great. But you’re dreading it ending—not because it’s so good, but because you always end up in pain afterwards. Maybe you don’t even want to start to begin with because it might hurt afterwards. Does this sound familiar? 

We hear a lot that folks are able to have pleasurable penetrative sex, but afterwards, it hurts! It’s a weird kind of frustrating to be experiencing pleasure that you know will result in pain.

What’s the culprit? What can you do to ease this pain? How can you kick this post-coital agony to the curb once and for all? 

What is pain?

We get it—it sounds like the most basic question. But when we talked to pelvic floor physical therapist Dr. Brianne Grogan, DPT, of Vibrant Pelvic Health, she explained that in order to help ease pain, we need to understand it first. “Pain is super complex,” she says. “The fascinating thing about pain is that it’s not just a ‘body experience’; rather, it’s a mind and body experience because [pain] is processed and interpreted in the brain.” 

In other words, while the issue might be happening in your body (like noticing pelvic pain after the act of having sex), your experience of pain is created by contributions from the body and mind, (which is made up of mental, emotional, spiritual, and even energetic components). 

“To be clear,” Dr. Bri says, “post-sex pain is absolutely real! You feel it in your body. 

But that reflexive protective tension in the muscles is a tangible, physical result of, potentially, another issue. There is more to the processing and experience of pain than tissue damage or bodily injury alone”—meaning, just because you have pain doesn’t mean you’ve injured yourself.

What can contribute to pain after sex?

You may have heard of the usual culprits: latex allergies, dermatitis, infections (like BV, yeast infections, and STIs), and vaginal dryness. But what if it's not any of these? What could be causing pain after sex?

Your muscles are too tight and/or tired

A lot of us carry tension in our pelvises and we might not even know it. A 2001 study showed that when the women who participated experienced stress or fear (due to the visual material they were shown), “both the pelvic floor muscles and the trapezius [neck and shoulder] muscle showed an increase in muscle activity.” The pelvic floor muscle tension was involuntary!   

Contrary to popular belief, a tense muscle does not equal a strong muscle, but a weak one. You may be able to successfully have penetrative sex, but once you’ve finished, your muscles are exhausted enough to cause an aching pain. Or these muscles are so tight, you may notice a burning sensation around your vaginal opening.

Why might your muscles be tense? We’ll examine that soon.

Insufficient lubrication

Okay okay, I know we already mentioned this one, but it's so important! Remember when we talked about that burning feeling in your vaginal opening after sex? That could also be from insufficient lubrication (among other things)! Whether you’re experiencing dryness from the most common culprits (hormonal changes and not enough pre-penetration sexy time prep work) or something else entirely, you might be feeling a little raw afterwards. In addition to dedicating more time to foreplay, this is where lube can be a super handy and immediately effective tool! 

An allergy to semen?! 

Another reason you may experience pain after sex is if you have a (rare, but real) allergy to semen. There are other symptoms to look out for, but take it from me that a sensitivity to semen is a very real thing. An official diagnosis would require testing, but I’ve learned myself that if semen comes into contact with my vagina or vulvar tissue, I have searing, burning pain that can last a few minutes to an hour. 

Chronic stress and anxiety 

If you’ve seen a professional and ruled out the above causes or other infections, that doesn’t mean there isn’t a reason for your pain. “Chronic stress and overwhelm puts your nervous system on edge and makes the ‘emergency response system’ in the brain go off more easily,” Dr. Bri says. 

Chronic stress and overwhelm? Who, us? It’s not like we live in a world rife with political, humanitarian, and natural disasters. 

Except yes, we do. Chronic stress and overwhelm are natural and normal responses to our current times. 

And not only can concerns and worries about the world around us create a dysregulated nervous system, but worrying about the pain itself can contribute, too.  

“Why is this pain happening? Will it happen next time I have sex? Will it hurt my relationship(s)?” Questions like this and how much you fixate or become hyper-aware of the pain, can lead to tension in our bodies, from our jaws to our hips—and often other places in between, according to Dr. Bri.

Furthermore, your body has a really good memory. It stores information from previous experiences—joyful, yes, but painful and/or traumatic experiences, too. If you’ve had pain after sex in the past, your body may start to anticipate it, which can then lead to the protective tension that causes the pain. It’s like a self-fulfilling prophecy. 

“You may be able to successfully have penetrative sex,” Dr. Bri says, “but your post-sex pain experience is a reaction that can be triggered, in this case, by stress or overwhelm. This pain may also include protective tension or bracing in the muscles of the hips, abs, and pelvic floor.” 

I only have pain after orgasm

For some folks, orgasm helps relieve pelvic pain. The quick contractions that occur during orgasm can actually help your muscles release. It’s not a perfect analogy, but think about holding tension in your bicep. Hold it, hold it, hold it, and then release. There is relief in that letting go after holding tension, right? It also gives us the contrast we need to recognize the difference between feeling tight and relaxed. So that Big O could actually help your pelvic floor muscles go “ahhhh” and chill out for a bit. 

For some people, however, they may experience pain after orgasm, rather than relief. Even though it’s a pleasurable and normal biological process to orgasm, the pelvic floor muscles are working hard, and you may have even felt the need to squeeze your pelvic floor muscles in order to reach orgasm. After your orgasm, your pelvic floor may feel tired and sore. This could be the result of a chronically too tight pelvic floor, or it could just be that today, your muscles are carrying a little more tension and the contractions from your orgasm are irritating them. 

It hurts during AND after sex! 

If you’re in the unlucky category of people who experience pain both during and after sex, it could still be your pelvic floor muscles! But it could also be due to more complicated diagnoses like endometriosis or PCOS, or issues that can be improved more easily like scar tissue or uterine prolapse. 

How do I ease pain after sex? 

We spoke to Dr. Sonia Bahlani, pelvic pain specialist, about easing post-sex pain. “It’s really going to depend on the cause of that pain,” she said. “Our job as clinicians is to empower patients and give them tools to understand when something is out of the ordinary and they should see a professional, or if it is what we call a flare.” 

Dr. Bahlani explains that if you’ve had a diagnosis in the past and something has worked for you (ie if you have vulvodynia and topicals have helped), then that might be what you reach for if you have a flare of pain after sex. 

Other helpful tools 

• Heat: if you have a pelvic floor flare up, heat relaxes muscles. Try a heating pad or warm bath. 

• Ice: if you have vulvo- or vestibulodynia (pain around your vaginal opening), ice or a cool pack in your undies can help. Caution: heat can cause these issues to flare! 

• Ohnut: if you normally notice you’re in the most pain after you’ve had deep penetration, give Ohnut a try! It can keep your partner from going in quiiiite so far without either of you having to worry about it.

While certain things are very individualized based on your past experiences with pain, there are some things anyone can do to help. This will not cure acute injury or infection, but it can support your healing. 

Calming your mind and body can ease your pain

“The nervous system is a servant of protection,” Dr. Bri says, “and it’s always scanning for threats. If the brain perceives a threat (real or imagined), it activates a pain response to protect the body. The good news is that neuroplasticity is a thing!”

I’m sorry, neuro-what? 

“Neuroplasticity means that the brain can change,” she says. “If it creates pathways that create post-sex pain, it can change to create new pathways that reduce this pain.”

Some things you can do to help ease pain after sex include:

• Calming the mind and body with deep breathing techniques. Focusing on long exhales is especially helpful
• Stretching and gentle movement. Rocking back and forth is very calming to the nervous system and these stretches are perfect for relaxing and releasing a tight pelvic floor
• Knowing that it’s going to pass. Remind yourself that the pain is temporary and you aren’t injured—your nervous system is just a little overactive. 

“That confidence can be empowering,” Dr. Bri says, “and it’s really important for easing this pain.”

Bonus tip: if the pain after sex is something you’ve come to expect, you can try all of these techniques before you even hit the sheets! Mentally and physically preparing your body for the potential of pain after sex can do wonders in easing it or even erasing it, if you consistently practice these techniques.