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Pain and nausea from sex?

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Katie asks:

My boyfriend and I have been sexually active for about two months now and were both virgins before this. We have always used condoms and it has always been enjoyable for both of us. However, many times after we have had sex I feel a dull ache around my lower abdomen or lower back area. I usually notice it within a couple of hours after sex. There have even been times when my stomache got upset afterwards and I have had pains from gas or simply got the runs. It is both uncomfortable and embarrassing. I was wondering if this is normal. What could be causing this? Is there anything I could do to fix it?

Heather Corinna replies:

There are a few likely possibilites for this.

One might be plain old vasocongestion -- when a person becomes sexually aroused, the whole pelvic area fills with blood, which is how erection happens in men, and vulval engorgement -- swelling of the clitoris and vulva -- happens in women. Sometimes, particularly if a person doesn't reach orgasm, that feeling can linger for a little while after sex. For men, that usually manifests as a feeling of discomfort in the testes, often colloquially called "blue balls." For women, it's usually a more general pelvic soreness. So, if you're not reaching orgasm during sex, that could be a cause, and even if you are, it could still be an issue.

If that's all it is, with or without orgasm a simple analgesic (pain reliever) will usually take care of that, as can a cool bath or shower or just waiting it out.

But since you also are brining up bowel issues and nausea, I'm inclined to think what you're feeling could also be a reaction to the increase of sex hormones you're experiencing with arousal. So, you may also want to discuss this with an endocrinologist. I'm not one myself (or anything even close), so I can't speak too much on that, but it's not impossible to have a hormonal imbalance that you're feeling most profoundly after sex.

Too, if you're not current with your sexual healthcare -- your annual GYN exam and STI screening -- go and get current. Chlamydia, for instance, can sometimes create the symptoms you're describing and it's incredibly common, especially in young women: if you've ever gone without condoms for vaginal or oral sex, than you could have been at risk. Endometriosis can also cause those types of symptoms.

I'd also just make sure that this isn't related to stress or anxiety. Conditions like IBS -- irritable bowel syndrome -- flare up whenever a person is stressed out, so if you're feeling any sort of stress or worry with your sexual activity, then take a good look at why and work towards managing those stresses and worries appropriately, by yourself and with your partner. And if you're feeling those symptoms at other times, too, have a chat with your general doctor or your gynecologist.

It's always -- always, always, always! -- best with any sort of persistent physical issue to see your doctor or other healthcare provider, just to be sure everything is okay.

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