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13 Causes Of Cramping After Sex & How To Find Relief, From A PT
Nothing ruins the afterglow like cramping after sex. Instead of basking in the postcoital euphoria, you're doubled over wondering how to get the pain to stop.
Many folks experience cramps after intercourse. And while this is a common complaint I hear from patients in my work as a pelvic floor physical therapist, it isn't normal, and there are things you can do about it.
Let's go over the top 13 causes of cramping after sex, how to ease the pain in the moment, and how to prevent it from happening in the future.
The need-to-knows:
- Cramping after sex is not necessarily a cause for concern: Since sex can be so taxing on the pelvic floor muscles, it can cause some residual pain and fatigue in that region.
- That said, it can signal a larger issue: If your cramping is severe, consistent, or accompanied by bleeding, swelling, fever, bloating, severe dizziness, or headache, talk to your doctor to rule out other issues like PCOS and endometriosis.
- You may be able to prevent cramps with healthy habits: Eating well, staying hydrated, prioritizing sleep, and strengthening the pelvic floor muscles can all help make your body more resilient to cramps in the future.
What causes cramping after sex?
There's no one reason that cramping occurs after sex—the causes are different for each person and situation. Here are a few potential reasons, from the benign to the more concerning:
Fatigue of the pelvic floor muscles
It's not surprising that sex can provoke muscle cramping. Research has shown that on average, sex involves moderate-intensity physical activity1, similar to jogging, swimming, or stationary rowing. Sex can be especially demanding of your pelvic floor muscles, which live at the base of your pelvis and help you hold in urine and stool.
These muscles also play a big role in sexual response. In a pelvis with a vulva, the bulbospongiosus and ischiocavernosus muscles push blood into the clitoris for erection. In a pelvis with a penis, the bulbospongiosus and ischiocavernosus muscles force blood into the penis for an erection, hold tightly to keep it erect, and strongly contract to help with ejaculation.
Your pelvic floor muscles are skeletal muscle, just like your calves and hamstrings, and are therefore susceptible to exercise-associated muscle cramps, or cramps brought on by the demands of physical activity, such as intercourse.
Dehydration or an electrolyte imbalance
Cramping also tends to increase in situations that induce fluid and electrolyte loss through sweating. So if you're dehydrated or low in electrolytes, this can cause cramps after sex as well. Here are some signs of dehydration and indications you could use more electrolytes.
Ovulation
Benign, midcycle pain, also known as Mittelschmerz2, affects over 40% of those with ovaries. At this phase of the cycle, levels of luteinizing hormone rise, which increases smooth muscle contractility and can cause pain that is felt on one side of the pelvis.
An IUD (particularly a copper one)
Intrauterine devices are generally known to cause cramping. A 2023 systematic review also found that copper IUDs might cause more cramping3 compared to hormonal IUDs.
Pregnancy
In a normal, low-risk pregnancy, cramping after sex is considered benign and normal.
Fibroids
In a 2017 survey of women with uterine fibroids (noncancerous tumors), 63% reported cramping4.
PCOS & ovarian cysts
In a 2017 study of women with polycystic ovary syndrome, 70% of subjects interviewed reported cramping5.
Interstitial cystitis
A study of female patients with interstitial cystitis (a condition that affects the bladder and can cause the frequent need to urinate) found that they reported abdominal cramping significantly more than female controls6.
Endometriosis
Painful cramping is also a common symptom of endometriosis, a painful inflammatory condition.
Prostatitis
In men, prostatitis7 (inflammation of the prostate gland) can cause painful ejaculation and pain after sex, including a feeling of cramping.
Urinary tract infection
UTIs can cause bladder spasms, which may feel like abdominal cramps.
Peyronie's disease
In Peyronie's disease, scar tissue forms in the penis and can cause penile pain, curvature, and sexual dysfunction.
STIs
Abdominal pain and cramping can be a sign of sexually transmitted infections, such as chlamydia and gonorrhea.
When to see a doctor
How to relieve cramps
Now that we know some of the reasons that cramping occurs, here are tips on how to find fast relief next time:
- Do gentle stretching and deep breathing: No surprise here: Stretching is the "fastest, safest, and most effective treatment" for any exercise-associated muscle cramp, according to exercise science experts8. While this is an easy suggestion if the cramp is in your calf muscle, it's a little trickier on the pelvic floor. One way to stretch your pelvic floor muscles is to breathe deeply until the cramping subsides. When you breathe in deeply, you create downward pressure, which cues the pelvic floor muscles to relax and stretch.
- Hold a deep squat: Squatting can also help relax a painful pelvis after sex. Hold on to a sturdy structure, like the back of a couch, and drop down into a deep squat. Hold for about 30 seconds. Do this three times.
- Try self-stretching with your hands: If you could use a more targeted stretch, take your hands to your perineum (between your genitals and anus) to touch a muscular tendon known as the perineal body. Gently sink your fingers into that tendon and pull it away from your genitals until you feel a stretch. Hold for about 30 seconds. Do this three times.
- Drink a salty beverage: Recovery drinks aren't just for athletes! If you have cramps, try hydrating with a sodium-packed drink. One study found that ingesting 1 mL of salty, briny pickle juice reduced cramping duration by 37%9 compared to ingesting water. Just note that you may not feel relief right away—fluids require about 13 minutes to be absorbed into the bloodstream.
How to prevent cramping after sex
To make sex a more pleasurable experience, here are some ways to prevent cramping from killing the mood in the future:
- Reduce muscle fatigue: By training the pelvic floor muscles, you can increase their capacity for physical activity and reduce the muscle fatigue they experience during sex. You can do this with pelvic floor contractions, also known as Kegels. To do a Kegel, squeeze and lift your pelvic floor muscles like you would hold in urine or gas. Then release. You will want to aim for 8-12 squeezes, 3 sets per day. (Pick up more exercises for strengthening your pelvic floor here.)
- Get better sleep: Sleep loss reduces the fuel stored in your muscles and causes you to reach exhaustion sooner. Prioritize high-quality rest with these pro tips.
- Reduce stimulants: Stimulants can increase the excitability of the nervous system and may increase cramping10, so keep your consumption of things like caffeine in check.
- Improve hydration and electrolyte balance: Be mindful of how much you sweat throughout the day, and be sure to replace both water and electrolytes. This in-depth guide to rehydration can help you.
- Make sure you're eating enough carbohydrates: Having enough fuel for increased physical activity can reduce fatigue, so be sure to eat enough healthy carbs throughout the day.
The mindbodygreen POV
Feeling pain during or after sex is fairly common—but that doesn't mean we have to grin and bear it. If you feel occasional pain in the pelvic region after sex, it could be a sign that pelvic floor exercises are in order. Staying hydrated, eating enough, sleeping well, and replenishing electrolytes will also help prevent cramps—in and out of the bedroom.
If your cramping after sex is severe or accompanied by other symptoms, experts recommend reaching out to your doctor to get to the bottom of it. Certain chronic conditions like endometriosis and PCOS are also associated with cramping, so you'll want to rule those out.
—Emma Loewe, mindbodygreen health & sustainability director
FAQ
Is it normal to get cramps after sex?
It can be normal to feel cramps after sex—particularly in the pelvic floor region. These are often caused by a hydration or electrolyte imbalance, or pelvic floor muscle fatigue. Cramps are not necessarily a cause for concern (though they can be sometimes).
What causes lower abdominal pain in females after sex?
Lower abdominal pain in females with uteruses can be normal after sex since both orgasms and semen can cause uterine contractions. However, there are many other possible causes for lower abdominal pain after sex. If your cramping is severe, consistent, or accompanied by any other symptoms, such as bleeding, swelling, fever, bloating, severe dizziness, or headache, you will want to discuss it with your doctor.
Are cramps after sex a sign of pregnancy?
While cramps can occur around conception due to implantation, they are not always a sign of pregnancy.
The takeaway
Cramping after sex is no fun, but it's not uncommon. When muscle cramping occurs, take deep, slow breaths as a way to gently stretch the pelvic floor muscles and relieve the pain. To prevent future muscle cramping, consider paying more attention to your hydration and sleep quality, as well as your carbohydrate intake before sex to fuel the muscles.
Training your pelvic floor muscles to reduce fatigue may also help you eliminate cramps and make sex less painful and more pleasurable.
10 Sources
- https://pubmed.ncbi.nlm.nih.gov/35147835/
- https://pubmed.ncbi.nlm.nih.gov/31747229/
- https://pubmed.ncbi.nlm.nih.gov/36847591/
- https://pubmed.ncbi.nlm.nih.gov/28836862/
- https://pubmed.ncbi.nlm.nih.gov/28821294/
- https://pubmed.ncbi.nlm.nih.gov/11458068/
- https://pubmed.ncbi.nlm.nih.gov/20704171/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775277/
- https://pubmed.ncbi.nlm.nih.gov/31696455/
- https://www.amjmed.com/article/S0002-9343(06)01025-4/fulltext
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