Does stomach pain after sex mean you are pregnant?
- Updated
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Created with Nataliia Yermolovych, MD, Obstetrician-Gynecologist
If you recently started noticing lower stomach pain after sex, it could be an early sign of pregnancy. However, abdominal pain after sex is also commonly associated with deep penetrative sex, infections, and vaginal dryness. Regularly noticing pain after sex requires medical attention to rule out underlying gynecological health conditions.
Lower stomach pain after sex can be worrisome, especially if you notice the pain every time you have sex. While any pain associated with sex requires medical attention, the causes of pain after sex can vary. On its own, pregnancy will not necessarily cause pain after sex; however, some early pregnancy signs could result in pain that you coincidentally notice after sex. Additionally, normal physiological processes, such as ovulation, or underlying health conditions could be the cause of lower abdominal pain after sex.
What are the common causes of stomach pain after sex?
1. Muscle strain
A common cause of stomach, pelvic, or back pain after sex could be due to muscle strain. It is possible to be in a relatively uncomfortable position during sex, and, in the heat of the moment, you forget that not all muscles are as flexible as you expected. This could result in mild pain or cramping in the lower abdomen after sex.
2. Deep penetration
Some sex positions favor deeper penetration, which subject the vaginal walls and cervix to repeated force during sex. This may be causing you discomfort after sex. If the pain is infrequent and usually subsides a few hours to a day after sex, deep penetration may be the cause.
3. Infections
The two most common types of infections that might repeatedly result in lower abdominal pain after sex are sexually transmitted infections (STIs) or a urinary tract infection (UTI). Chlamydia and gonorrhea are the most common types of STIs. Pain during or after sex (dyspareunia) can be a non-specific symptom of an underlying STI and is sometimes the only sign. Additionally, you may also notice burning during urination, abnormal vaginal discharge, and bleeding after sex.
Similarly, since the urinary tract is anatomically quite close to your vagina and cervix, sex can result in pain to an infected urinary tract. UTIs also cause increased urinary frequency and a burning sensation when you pee.
For most infections, all these signs may not present simultaneously. Persistent abdominal pain after sex may be the only sign, which makes checking in with your doctor important.
4. Vaginal dryness
Sex with minimal lubrication can result in pain and soreness after sex. Certain medications, menopause, hormonal fluctuations, and sometimes longer durations of sex can all result in vaginal dryness. While you may notice discomfort during sex, the pain can persist for a while even afterwards.
5. Ovulation pain
Having sex while you are ovulating can occasionally cause lower abdominal pain. Ovulation pain, also known as Mittelschmerz, results in cramping often felt on one side of the lower pelvis. 40% of women in their reproductive age can identify their ovulation pain. Having sex during ovulation can heighten this pain during or after sex, but a positive of having sex during this time is that it increases your chances of getting pregnant.
👉Find out more: Pelvic floor massage 101: How to relieve pain and improve function
6. Uterine tilt
In a study of 111 pre-menopausal women, 67% of those who recorded pain during sex had a retroverted uterus—one that is tilted backward toward the spine. Certain sex positions that favor deeper penetration, such as the doggy style, might be more likely to cause lower stomach pain after sex with a retroverted uterus.
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Lower abdominal pain after sex: Am I pregnant?
Pain or mild discomfort noticed during or after sex can be a symptom of pregnancy or a result of the hormonal fluctuations noted during pregnancy.
Early pregnancy
Pain can work as an indicator when you get a positive pregnancy test. Following fertilization, your egg travels into the uterus and implants into the endometrium. Implantation can result in pain, which can be heightened after sex.
Lower abdominal pain linked to implantation is noticed 6 to 10 days after ovulation—the timeframe it takes the fertilized egg to travel to the uterus.
Hormonal changes
During the first few weeks of pregnancy, progesterone and human chorionic gonadotropin (hCG) are the primary circulating hormones. Both these hormones work together to favor healthy uterine, placental, and fetal growth. However, while they provide benefits during your pregnancy, these hormones, especially progesterone, are known to cause pain, fatigue, and breast tenderness in the first few weeks of pregnancy.
You may notice a sudden shift to consistent discomfort and lower stomach pain after sex in your early weeks of pregnancy.
So, while not a confirmatory indicator of pregnancy, persistent discomfort after sex, coupled with a missed period and early pregnancy signs, might warrant a pregnancy test.
Pregnancy testing
While physical signs such as a missed period, implantation bleeding, fatigue, and lower abdominal pain after sex might be providing hints that you are pregnant, the only way to be sure is to take a pregnancy test.
A home pregnancy test can detect early rises in hCG levels almost as soon as you miss your period. If negative at first, a repeat of the test a week later might come back positive. Your OBGYN can conduct a blood test to give you an early confirmation or if home pregnancy kits are showing up negative but you still suspect.
What are some other possible causes of lower stomach pain after sex?
A lot of the causes listed above can result in brief lower abdominal pain after sex. Changing your sex position or having your infection treated can reduce pain and other discomfort you notice after sex. However, persistent pain associated with sex, especially if present as the only symptom, could warrant a check-up with your doctor for an underlying gynecological condition.
1. Endometriosis
Endometriosis is a gynecological condition where the tissue of the uterine lining, the endometrium, grows outside the uterus. A primary symptom of endometriosis is dyspareunia, or lower pelvic pain noticed during and after sex. Since stomach pain after sex is often the only symptom of endometriosis, it can frequently be dismissed, delaying diagnosis and treatment.
2. Fibroids
Fibroids are abnormal outgrowths from the muscular walls of the uterus. Approximately 25% of women in their reproductive age document having clinically apparent fibroids, where symptoms can include lower pelvic fullness, bloating, heavy periods, and pain after sex.
3. Pelvic inflammatory disease (PID)
Untreated or recurrent STIs, such as gonorrhea and chlamydia, can result in pelvic inflammatory disease (PID). Along with vaginal discharge and painful periods, pain during and after sex is a symptom of PID. This was recorded as a common symptom in a study of 168 Jordanian women, where dyspareunia was seen in 27% of women. If you suspect you have PID, visit your doctor to get prompt treatment, as PID has been linked with miscarriage and infertility.
4. Ovarian cysts
Ovarian cysts are small fluid-, pus-, blood-, or air-filled sacs that form in the ovaries. They are relatively common, especially around ovulation, and the majority are benign and subside on their own. However, while the cysts are present in the ovary, they can result in lower pelvic discomfort, especially observed as lower abdominal pain during and after sex. If the pain intensifies or remains persistent, consider checking in with your doctor.
5. Pelvic floor muscle dysfunction
The muscles in your pelvic floor support vital organs such as your vagina, uterus, urethra, anus, and rectum. A dysfunction in the muscles could result from trauma, surgery, pregnancy, childbirth, or age. Pelvic floor muscle dysfunction can result in losing your voluntary ability to contract the muscles in your pelvic floor. This could lead to either excessive muscle relaxation or contraction, both of which can cause stomach pain after sex.
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When should I see a doctor?
The lower stomach pain you experience after sex can frequently be associated with muscle strain, use of a new sex position, or vaginal dryness. You can reduce this pain simply by being more mindful of the positions you use during sex or using additional lubrication if you feel that vaginal dryness is the reason for your pain after sex.
If the lower abdominal pain persists after a few days, consider a check-in with your OBGYN. Experiencing any other symptoms along with painful sex should also warrant a prompt doctor’s appointment.
1. Persistent pain
Pain that lasts much longer after intercourse and persists throughout the day is an indication that something could be amiss. Pain increasing in severity, especially during and after sex, are signs of conditions such as endometriosis or pelvic inflammatory disease.
2. Fever
Having a fever, especially one that is high, is a tell-tale sign of an underlying infection. It becomes an alarm symptom when it persists even with over-the-counter medicines and is present with other symptoms such as vaginal discharge, pelvic discomfort, chills, and changes in your appetite.
3. Vaginal discharge
Having some vaginal discharge is normal throughout your menstrual cycle. However, when you notice changes in consistency, color, and smell, it could signal an underlying infection. Vaginal discharge is also a sign of PID, along with pelvic discomfort, and lower abdominal pain after sex.
4. Unusual symptoms
The new onset of any symptom that you initially never noticed, coupled with lower stomach pain after sex, should prompt you to make an appointment with your doctor right away.
Your doctor will evaluate your symptoms as a whole and conduct relevant tests. Most of the conditions that could be causing your lower abdominal pain after sex are treatable with early diagnosis.
Questions from the Femia community
Is it normal to have stomach pain after sex?
Mild discomfort based on the positions you used during intercourse, or if penetration was deep during sex, could result in mild stomach pain after sex. Most of this pain subsides in an hour or two. However, if your pain is persistent, is noticed every time after sex, and increases in severity, consider checking in with your doctor.
Is lower abdominal pain after sex more common in certain positions?
Certain sex positions favor deeper penetration, which can cause pain during or after sex in the lower abdomen. This pain subsides and is usually not noticed every time you have sex.
I have lower abdominal pain during sex, could I be pregnant?
Yes, on some occasions, persistent mild lower abdominal pain during sex could be an early sign that you are pregnant. It could either be due to the implantation of your fertilized egg into the uterus or because of the early pregnancy hormonal fluctuations. You can confirm pregnancy by taking a pregnancy test at home.
Can birth control methods cause lower abdominal pain after sex?
For some, hormonal birth control might be a reason for abdominal pain, sometimes heightened after sex. If you have recently started using a new form of hormonal birth control and feel it could be the reason for your pain, consider talking to your healthcare provider.
Will my period start if I notice stomach pain after sex?
During the luteal phase of your menstrual cycle, you may have observed occasional discomfort after sex. For some, abdominal pain after sex could be present as a sign of PMS and vanishes as soon as your period starts. So, cyclical pain coupled with premenstrual symptoms could be a sign your period is around the corner. However, in this case, the pain should be mild and go away quickly. If it is persistent, severe, and lasts even after your period, check in with your doctor.
The bottom line
Lower stomach pain after sex could be an early indicator of pregnancy. This might be coupled with a missed period, implantation bleeding, sore breasts, changes in your mood, and fatigue. Taking a pregnancy test or having your doctor take a blood sample can help confirm this for you. However, in some instances, lower abdominal pain after sex can be noticed with deep penetrative intercourse, muscle strain, vaginal dryness, or underlying infections. Most of these are easily managed, and the pain should reduce over time. However, if your pain after sex is persistent, and you notice other symptoms such as vaginal discharge, changes in your period flow, fever, and pelvic discomfort, it is advisable to check in with your doctor for a more comprehensive treatment plan.
References
- Mitchell, Kr, et al. “Painful Sex (Dyspareunia) in Women: Prevalence and Associated Factors in a British Population Probability Survey.” BJOG, vol. 124, no. 11, Jan. 2017, pp. 1689–97. https://doi.org/10.1111/1471-0528.14518.
- Fauconnier, Arnaud, et al. “Mobile Uterine Retroversion Is Associated With Dyspareunia and Dysmenorrhea in an Unselected Population of Women.” European Journal of Obstetrics, Gynecology, and Reproductive Biology/European Journal of Obstetrics & Gynecology and Reproductive Biology, vol. 127, no. 2, Aug. 2006, pp. 252–56. https://doi.org/10.1016/j.ejogrb.2005.11.026.
- Brott, Nathan R. and Jacqueline K. Le. “Mittelschmerz.” StatPearls, StatPearls, 2023. https://pubmed.ncbi.nlm.nih.gov/31747229/.
- Su, Ren-Wei, and Asgerally T Fazleabas. “Implantation and Establishment of Pregnancy in Human and Nonhuman Primates.” Advances in anatomy, embryology, and cell biology vol. 216 (2015): 189-213. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5098399/.
- Wahl, Kate J., et al. “Dyspareunia in Their Own Words: A Qualitative Description of Endometriosis-Associated Sexual Pain.” Sexual Medicine, vol. 9, no. 1, Dec. 2020, p. 100274. https://doi.org/10.1016/j.esxm.2020.10.002.
- Stewart, Ea, et al. “Epidemiology of Uterine Fibroids: A Systematic Review.” BJOG, vol. 124, no. 10, May 2017, pp. 1501–12. https://doi.org/10.1111/1471-0528.14640.
- Al-Kuran, Oqba, et al. “How Prevalent Are Symptoms and Risk Factors of Pelvic Inflammatory Disease in a Sexually Conservative Population.” Reproductive Health, vol. 18, no. 1, May 2021, https://doi.org/10.1186/s12978-021-01155-2.
- Knudsen, Ulla Breth, et al. “Management of Ovarian Cysts.” Acta Obstetricia Et Gynecologica Scandinavica, vol. 83, no. 11, Oct. 2004, pp. 1012–21. https://doi.org/10.1111/j.0001-6349.2004.00607.x.
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