If you’ve ever found yourself close to climax—only to feel a sharp or nagging pain right when you reach the top, or soon after—you may have experienced Dysorgasmia. Also known as painful orgasm, this condition can be distressing (due to the alarm and anxiety of wondering where that pain is coming from or what caused it or how long it will last), especially considering it occurred while you were in the throes of an otherwise satisfying sexual experience. And while climaxing isn’t necessarily the be-all and end-all of fulfilling sex, orgasms should ultimately be pleasurable, not painful.
Unless ruined orgasms are your thing, painful sex is generally not considered normal. In fact, it could be a signal from your body that there’s an underlying condition or pelvic floor issue—one that you should definitely get checked out.
Dysorgasmia is the medical term for pain experienced during or after orgasm, usually in the abdomen. It’s typically the result of a muscle contraction or spasm that involves the muscles of the pelvic floor or the uterus. To understand the mechanisms here, it’s helpful to clarify what an Orgasm is at its core: a neurophysiological culmination ending with an involuntary muscle spasm.
Of course, there’s more to that simplified story, but as to why the pain occurs? Physiologically speaking, it’s similar to how if you were to contract the muscles in your arm, there’s a release and relaxation of those muscles afterward. With an orgasm, if those pelvic muscles that contract during orgasm don’t fully release afterward, it can lead to pain and tightness. Painful orgasms can be a common occurrence for adults, no matter their age or sexual anatomy. “Some people find that pain with orgasm is all they know, but it’s not normal and certainly not something that you need to accept,”.
While the pain of dysorgasmia can be different for everyone, if you’ve ever experienced menstrual cramps, general abdominal cramps, ovulation pain, or pain related to endometriosis, then you’re in the neighborhood. Dysorgasmia may feel like a muscle spasm in your abdomen (similar to the type you’d get from menstrual cramps) or a strange pulling sensation deep within your pelvic floor. The pain itself can range from mild to severe, and onset and duration of pain can also vary greatly. It’s all these variables that can make dysorgasmia difficult to identify. Doctor says “Some people will have pain immediately, feeling a sharp, shooting pain as they’re orgasming,”. “Other times, people will have delayed pain. They may have achiness, tightness, gnawing pain, or dull pain afterward. It might start 15 minutes later, it might start four hours later, or they may just notice it throughout the following day.”
Interestingly, you can experience pain elsewhere in your body following an orgasm, too, including facial or ear pain, foot pain, headaches, and emotional pain such as panic attacks. The mechanism for this other, less localized pain remains unknown.
There is an expansive range of potential causes of dysorgasmia, both physical and emotional. And sometimes both factors may be at play.
There is Pelvic floor dysfunction
By far, the most common cause of dysorgasmia in those with vulvas is pelvic floor dysfunction. Think of the muscles of your pelvic floor like a basket that supports your pelvic organs. “If those muscles are too short and tight, and then your orgasm causes a contraction that pulls on those muscles repeatedly, that can cause residual pain.
There is also Endometriosis, uterine tissue (endometrium) may start to grow outside of the uterus (where it does not belong), causing scar tissue buildup in and around the pelvis that can be incredibly painful during sex or orgasm. If you’re living with endo, as it’s known in the community, you may also have long, heavy, painful periods, menstrual cramping, low-back pain, and pain with bowel movements or urination.
Like Endometriosis, Adenomyosis is a uterine lining problem. While the two conditions share similar symptoms (cramps, pelvic pain, low back pressure, heavy periods), there is one major difference. The uterine tissue in adenomyosis builds up inside the uterine walls, growing thicker with each menstrual cycle, and may eventually break through the uterine muscle wall. Because this condition can result in an enlarged uterus, your abdomen may be more tender and sensitive to pressure, resulting in pain with orgasm/sex.
There is also Pelvic inflammatory disease (PID) which is an infection of the reproductive organs usually caused by a sexually transmitted infection (STI) or other infection that has traveled from the vagina into the uterus or beyond into the fallopian tubes and/or ovaries. Symptoms can include pelvic pain during urination or sex, bleeding during sex, as well as fever and a change in discharge.
Fibroids are noncancerous tumors that grow in the uterine wall. While they are almost always benign and may not cause symptoms, some larger fibroids may cause the uterus itself to enlarge, which can result in significant pain. Prolonged or heavy periods, back or pelvic pain, and abdominal pressure, especially during penetration, are common symptoms. An enlarged uterus may also put pressure on your pelvic floor muscles, causing pain during orgasm.
There is also Ovarian cysts which are fluid-filled sacs that may appear in your ovaries after ovulation each month. They tend to form and then disappear, but in some circumstances, they can hang around for a while, increase in size, or even rupture. You may feel pain with penetration during sex, or pain with orgasm more on one side of your body than the other, as cysts tend to be localized more on one ovary (left or right).
Often mistaken for a Urinary Tract Infection (UTI), Interstitial Cystitis (IC) is a chronic bladder condition also known as painful bladder syndrome. It can result in a frequent urge to urinate (just like UTI), pelvic pain or pressure, and major discomfort during sex/orgasm due to an irritated, inflamed bladder.
A type of inflammatory bowel disease (IBD), Crohn’s disease is marked by inflammation of different areas of the digestive tract, leading to serious pelvic pain, as well as severe diarrhea, fatigue, weight loss, and blood in the stool. This inflammation can result in major tenderness in the abdomen, and so—at the very least—sex and orgasms may not feel as pleasurable as they can/should, or, plainly speaking, they could downright hurt.
If you have Irritable Bowel Syndrome (IBS), you will likely experience abdominal pain, cramping, bloating, gas, and regular diarrhea and/or constipation, and the resulting pelvic pain can make sex or orgasm uncomfortable. Arousal or orgasm may also make your IBS symptoms worse after climax, which experts believe may be caused by increased blood flow to your pelvis or contractions of the uterus, which is snuggled right up against the intestines and can irritate them.
If you’ve had a Vaginal delivery that resulted in a perineal tear, you may have scar tissue that’s causing problems now with orgasm. Scar tissue can cause tightness in your pelvic floor, even if your pelvic floor muscles are lax.
It comes back to scar tissue again here: The healing processes from a cesarean-section or laparoscopic surgery can pull on your pelvic muscles in a way that’s new and different because the myofascial structure has changed post-surgery. You’re basically changing the lattice of how your pelvic floor works, meaning that an incision anywhere in your pelvis, even a tiny one from laparoscopy, could have major effects on how your pelvic muscles function afterward.
Don’t overlook a history of emotional or sexual abuse as a reason for your pain. The mind-body (somatic) connection is powerful, and it’s the previous experience of emotional pain or trauma that can sometimes cause the physical issue to endure. We’re learning more and more that the inherent link between our emotional and psychological well-being is deeply rooted in our bodies. Emotional experiences are literally held in the body, and the body is essentially where the subconscious lives. Relationship issues, stress, and sexual trauma are all potential psychological causes for experiencing pain [and deriving less pleasure] from sex. Just as an exhausting workday can manifest as physical tension in your neck and shoulders, pelvic floor tension could also be related to an emotional experience that’s been long-held in the body. Working with the nervous system to integrate those underlying emotional susceptibilities is essential to healing.
If you’re having pain after orgasm, there are other techniques, like diaphragmatic breathing, that can be done after sex to mitigate tension. But that’s only part of the puzzle, because if there’s pain, there’s usually something else going on there. That’s why getting an evaluation or speaking to your health care provider first is important: to look into the underlying causes about why pain is occurring.
If you have a hunch that your pain may stem even partly from emotional or sexual abuse, don’t hesitate to reach out to a Sex therapist who can help you heal. Even something as seemingly insignificant as being raised in a sex-negative household can mean you’re holding on to internalized shame around sex, and that can make it hard for the mind to relax. That closed-off mental-emotional state can be translated into tension or tightness in your pelvic muscles when you’re having sex. A Sex therapist can help people change the negative thoughts that might contribute to or amplify the pain. Sex therapists can also offer tools such as relaxation exercises and guided meditations or visual imagery that can help with pain management. The sooner you seek help for your pain, the better, the longer a person waits, the more likely they will develop secondary issues, such as low desire.
Don’t wait till dysorgasmia starts interfering with your sex life on a deeper level. The brain learns, if you start experiencing anxiety or fear related to pain while having sex, your brain can centralize that feeling and start clamping down those muscles even more. Putting it off could just perpetuate the vicious cycle.
If you have a hunch that dysorgasmia is happening to you, too, speak to your doctor. Painful orgasms aren’t something you should just shove under the covers—you deserve to have satisfying sexual experiences that aren’t uncomfortable or painful. People should be able to achieve orgasm without pain. Painful orgasms aren’t normal, period. If your pain is recurring, tune in to your body’s signals and get a checkup. While it may take some time, effort, and energy to get to the bottom of what’s causing your discomfort, know that treatment—and pain-free pleasure—are in reach.
Mindbodygreen.com
