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What Every Woman Should Know About Pelvic Cramping After Sex

Posted March 21, 2022

Experiencing pelvic pain before, during, or after sex is quite the mood killer and can be uncomfortable to handle. If the pain is severe and occurs frequently, there may be a more serious underlying issue that needs medical evaluation. 

Feeling pain after sex can likely be due to STIs, fibroids, emotional trauma, endometriosis, UTIs, deep penetration, or dysmenorrhea. No matter the case, it is crucial to seek out a medical provider who can take a look at what is going on on the inside to receive the treatment you need. 

Below, we will take an in-depth look into a common cause of pelvic pain after sex, how medical providers evaluate it, and the types of treatment and diagnoses. 

Dysmenorrhea As a Common Cause of Pelvic Pain

Sometimes sex isn’t a pleasurable experience for either a man or a woman. If you’re experiencing pelvic pain after sex, there may be a more serious issue within your organs. 

Dysmenorrhea is a common condition where women experience extremely painful periods. However, many cases of dysmenorrhea go undiagnosed since many women are unaware that they may be suffering from it. 

A more clinical definition of dysmenorrhea is when patients experience painful monthly bleedings characterized by lower abdominal pain and is associated with significant psychological, physical, and emotional impacts. 

What Causes Dysmenorrhea? 

You may be wondering about what is happening in your body at the time of extreme pelvic pain during menstruation. Medical studies have identified the hormone prostaglandin F (PFG) as the primary cause. 

For primary dysmenorrhea, the release of PFG causes major contractions within the uterus when the lining is shedding. The more prostaglandin released, the more intense the pain will be. 

Secondary dysmenorrhea is associated with medical conditions such as endometriosis, pelvic inflammatory disease (PID), uterine fibroids, or infections (which are also causes of pain after sex). 

Dysmenorrhea Caused by Pelvic Congestion Syndrome


Patients with varicose veins high up in the thighs, groin, vulvar region, and at the back of the thighs have a higher chance of having Pelvic Congestion Syndrome (PCS). 

In most cases, varicose veins of the leg tend to improve in the months after delivery as may the veins in the pelvis. However, in many others, the dilated veins persist both in the legs and in the pelvis, after giving birth. Pelvic veins tend to stretch during birth. These enlarged veins have valves that don't function as expected causing pelvic pain and dysmenorrhea. If the patient had multiple births, pelvic pain, and any gynecological condition is ruled out by a physician, then the patient will go under further diagnosis by a vasular specialist to determine the cause of the symptoms. 

The photo above shows an Gynecologist who conducted a proper transvaginal ultrsound showing (right) pelvic varicosities by using the color blocks. This shows the patient is 95% sensitive that there is a pelvic venous insufficiency source. 

Dysmenorrhea Signs & Symptoms

There has to be no evidence of other disorders that could account for the pain for a diagnosis to occur. When there is no hint of another cause of pain, it is likely due to dysmenorrhea, which can cause many uncomfortable symptoms. 

  • Pain and cramping of the lower abdomen
  • Pain in upper thighs and lower back
  • Headaches
  • Vomiting
  • Diarrhea
  • Fatigue 
  • Weakness
  • Fainting  

Between 16% to 29% of women experience a significant disruption of daily life activities due to symptoms of dysmenorrhea. It is worth getting checked out, so you and your body can get back to enjoying regular activities, like sex. 

How Pelvic Pain is Evaluated 

You may need to get evaluated for chronic pelvic pain if you experience any abnormal pain after sex or have the symptoms listed above. 

Menstrual History

Your menstrual cycle will be able to tell your medical professional a lot about your chemical balance and symptoms. 

If your cycle is irregular, painful, and heavy, then the likelihood of having endometriosis or fibroids may be higher than other diagnoses. 

Painful periods with nausea, vomiting, headaches, and fatigue can rule in dysmenorrhea as the potential cause of your pelvic pain. 

Timing of Pain

The time your pain occurs can let medical professionals understand what may be causing pelvic cramping. If it is mostly after sexual intercourse, it can be due to conditions like endometriosis. 

Characteristics and Severity of Pain

Things like your pain level, location, and progression are needed to determine if your pelvic pain is attributed to a medical condition. 

Medical professionals will ask multiple questions regarding your pain when you are menstruating, when and where in your body it occurs, for how long, and how painful it is. 

Sexual History

If you have an active sex life, experiencing pain is highly uncomfortable and frustrating. However, these symptoms could be caused by STIs or UTIs, which often accompany a person through sexual intercourse. 

Past Medical History

Sometimes pelvic pain can be caused by the prevalence of your past medical conditions. If you are prone to or have a condition like endometriosis or vaginismus, that can be a telltale sign of chronic pelvic pain. 

Prior Treatments

When being evaluated, there are usually questions that revolve around any past treatments you have received. This allows medical providers to see more into your medical history for other medical conditions or abnormalities you’ve experienced. 

Physical Examination

With pelvic pain, there are uncomfortable symptoms of the physical kind. Physical examinations such as ultrasounds, imaging scans, or invasive producers may be used when being evaluated by a medical provider. 

Performing A Pelvic Ultrasound

What Does it Do? 

Pelvic ultrasound alone may not be able to form a diagnosis. Still, they do help to look at the pelvic vein and lower abdomen to see if conditions symptoms are of a vascular origin.

 

An ultrasound gel is placed on the transducer and the skin to allow for smooth movement of the transducer over the skin and to eliminate air between the skin and the transducer for the best sound conduction. This is NOT a transvaginal ultrasound where a tube is placed inside the vagina. It is a transabdominal ultrasound, similar to sonogram performed when determining sex of the baby. 

How Does it Work? 

Transvaginal ultrasounds uses a transducer that sends out ultrasound waves at a frequency too high to be heard. The ultrasound transducer is placed on the skin, and the ultrasound waves move through the body to the organs and structures within. The sound waves bounce off the organs like an echo and return to the transducer. The transducer processes the reflected waves, which are then converted by a computer into an image of the organs or tissues being examined.

Not all patients are given a transvaginal ultrasound or pelvic ultrasound. The provider will determine if the ultrasound is needed based on a proper questionnaire and evaluation that CVM standardized when treating hundreds of similar patients. 

How is Pelvic Pain Diagnosed? 

Thorough physical examinations, medical history, and ultrasounds are used to diagnose pelvic pain, determining if dysmenorrhea is the culprit of such pain. 

Medical providers typically evaluate patients for pelvic pain by: 

  • Medical History: Most medical providers will look at your medical history to better understand what might be causing you pain. Sexual history, menstrual history, history of pregnancy are useful in diagnosing pelvic pain. 
  • Laparoscopy: This test uses a tube and scope that is inserted into the abdomen to capture images of the internal pelvic tissue. 
  • Imaging Tests: Ultrasounds, CT, or MRI scans may be used to determine the cause of your pelvic pain. 

How We Can Help

Our world-class medical providers use state-of-the-art imaging equipment to ensure every patient receives quality care and the support they need to make the right decision regarding their health. 

The Center for Vascular Medicine advises women experiencing these pains to visit their gynecologist for evaluation before setting up a visit for a vascular specialist. AT CVM, we have diagnostic procedures that verify out findings like IVUS (Intravascular-ultrasound) and venogram along with a dye to view the blood flow in the veins. The provider will direct you to the best options for you based on the findings, past medical history, age, how symptoms impact the quality of your life, and most importantly the results of patients who have experienced similar conditions. 

If you’re experiencing any of the symptoms above, then get in touch with us today so we can get you taken care of. 

 

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Chronic Pelvic Pain
Pelvic Congestion Syndrome
Pelvic Pain
Physician Chronic Pelvic Pain
Dr. Sanjiv Lakhanpal

Dr. Sanjiv Lakhanpal

Dr. Sanjiv Lakhanpal published in several medical research journals through the Lakhanpal Vein Foundation to help educate and raise awareness for vascular disease. He has been practicing medicine for 25 years, and is the founder of The Center for Vascular Medicine.

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