Most of the time sex feels great, so it can be unsettling when you feel pain after intercourse. For some men, the pain can trigger performance anxiety and may diminish interest and pleasure during intercourse.
Causes for the pain vary depending on your sexual and general health, but one of the most common reasons include a condition called prostatitis, which affects up to 15 percent of the male U.S population.
The Most Common Reason: Prostatitis
Your prostate gland produces the fluid that surrounds semen and is essential for male fertility. When the prostate’s tissue becomes inflamed, it causes prostatitis. Common symptoms of prostatitis are recurring chronic pain or aches, usually affecting the:
- Lower back
- Central lower abdomen and pelvis
- Perineum — the space between the scrotum and anus
Acute prostatitis is usually caused when bacteria from the urinary tract enters the prostate. With chronic prostatitis, the reasons for infection are less clear. Since urinary tract infections (UTIs) and sexually transmitted infections (STIs) can carry bacteria into the prostate, they are major risk factors, depending on a man’s age and sexual history.
Antibiotics usually are prescribed to treat prostatitis, depending on the kind of bacteria that caused the infection. Anti-inflammatory and pain medications also can help. Your doctor might recommend imaging to determine whether additional issues, such as an abscess, may be hindering recovery. Even after treatment, you still might feel some discomfort for weeks or even months. Your doctor might recommend exercises that can help with rehabilitation or relaxation in the pelvis.
Other Reasons for Pain After Sex
While prostatitis might be one of the most common reasons men feel discomfort after sexual activity, it’s not the only reason. Here are six others:
Peyronie’s Disease, or penile curvature. When fibrous scar tissue forms on the penis, it can cause curved, painful erections. This can lead to erectile dysfunction, stress, anxiety and sometimes penile shortening. Peyronie’s is a common, noncancerous condition and can be treated with pain medication like NSAIDs, injections that break down the scar tissue once the pain has resolved, or even with surgery if you’re also experiencing erectile dysfunction.
Penile fracture. The tunica albuginea is the rubbery sheath of tissue beneath the penis’s skin, which allows the penis to increase in width and length during erection. Sometimes this tissue can tear or rupture, which is cause for a trip to the emergency room and likely surgery. Taking care of this condition quickly can avoid permanent and further urinary and sexual health problems.
Overly tight foreskin. If you’re uncircumcised, the head of the penis is covered by tissue called the foreskin. Normally, this tissue retracts during intercourse. But if you have an overly tight foreskin, a condition called phimosis, the foreskin can’t retract because the skin is too tight, causing pain. Over time, the friction of this movement can cause it to tear or become inflamed or infected. Treatment may involve steroid cream or circumcision if the pain persists.
Undescended testicle. This is an unusual cause of sex-related pain, but it can happen. During the last weeks before or soon after birth, the testicles usually descend from the abdominal area into the scrotum, the skin below the penis. When this doesn’t happen, it’s called an undescended testicle. This can result in a squeezing pain during sex, particularly if the testicle is lodged in the groin or the lower abdomen. Surgery is the most common treatment and generally involves removing the testicle.
Groin hernias. This can occur when tissue protrudes through a weak spot between your lower abdomen and thigh, usually if there’s an opening in the muscle wall that should have been closed at birth. The most common sign is a bulge or lump that pushes through the weak spot. This causes pain in the groin area, particularly during straining activities, including intercourse
Scar tissue from previous treatments. If you’ve had surgery and scar tissue is near your abdomen, the pelvis or the perineum, it could trigger discomfort or pain during or after sex. Previous infections, trauma or other injuries can also leave scar tissue or nerve injuries. Cases of superficial scar tissue may be treated with surgery, while minor scarring may be treated with topical salves to loosen the tissue. Chronic deep pelvic pain and nerve scarring can be difficult to treat and generally involve pelvic physical rehabilitation and pain management.
If you experience pain during or after sex only one time, it may just be a muscle sprain or a mild condition that will heal on its own. But if you regularly have intercourse-related pain, you should speak to your doctor.
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