From the Research
For uterine pelvic pain occurring only after orgasm (post-orgasmic pain), I recommend starting with over-the-counter NSAIDs like ibuprofen (400-600mg) or naproxen sodium (220-440mg) taken 30-60 minutes before sexual activity. This condition, sometimes called dysorgasmia, can result from temporary uterine contractions during orgasm that may cause pain in some women 1. If OTC medications don't provide relief, consult a gynecologist who might prescribe stronger medications like prescription-strength NSAIDs or low-dose muscle relaxants. Applying a heating pad to the lower abdomen after intercourse may also help relieve discomfort. Some women benefit from pelvic floor physical therapy to address any underlying muscle tension, as evidenced by the benefits of pelvic floor physical therapy in treating pelvic floor dysfunction 2. Hormonal factors can sometimes contribute to this pain, so tracking symptoms throughout your menstrual cycle may reveal patterns. Since the pain occurs only after orgasm and not during penetration, this suggests the issue may be related specifically to the muscular contractions of orgasm rather than a condition like endometriosis or infection. If pain persists or worsens despite these measures, a thorough gynecological evaluation is essential to rule out conditions like adenomyosis, fibroids, or other structural issues that might be contributing to the post-orgasmic pain.
Key considerations in managing post-orgasmic pain include:
- The use of NSAIDs or other pain relievers before sexual activity
- Pelvic floor physical therapy to address muscle tension
- Tracking symptoms throughout the menstrual cycle to identify patterns
- Ruling out underlying conditions like adenomyosis, fibroids, or endometriosis through a thorough gynecological evaluation
- Considering the potential benefits of low-dose muscle relaxants or other medications under the guidance of a gynecologist
It's also important to note that while pelvic floor physical therapy has shown benefits in treating pelvic floor dysfunction 2, its effectiveness in specifically addressing post-orgasmic pain may vary, and more research is needed to fully understand its impact on this condition 3. Nonetheless, given the potential benefits and the importance of addressing pelvic floor muscle tension, pelvic floor physical therapy is a recommended approach for women experiencing post-orgasmic pain, in conjunction with other management strategies.