Pain during sex is common, but that doesn’t mean you have to live with it. Deep penetration is the most likely cause of painful intercourse in females, but it can also be caused by a gynecological condition.

Though this article will focus primarily on painful intercourse in females, we know that males can experience abdominal pain during sex, too. We’ve got you covered.

Regardless of the cause, painful sex can be treated. Your healthcare provider can recommend therapies to help you get back down to the business of pleasure without the pain.

Here’s what to watch out for and when to see a professional.

Pain during sex often comes down to your position or the position of your uterus.

Position

Some sexual positions allow for deeper penetration during vaginal or anal sex, which could cause pain.

The best remedy in this case is to avoid deep thrusting and try other positions, like on your side. Positions where you have control over the depth of penetration can also help, such as being on top.

Tilted uterus

A tilted uterus is a uterus that leans backward at the cervix instead of tipping forward. About 1 in 4 women have a tilted uterus. While having one isn’t generally a problem, it can sometimes make sex — especially certain positions — painful.

Your gynecologist can tell you whether or not you have a tilted uterus. Experimenting with different positions and angles can help you find one that doesn’t hurt.

In some cases, lower abdominal pain could be a sign of an underlying condition.

Endometriosis

With endometriosis, the tissue that lines your uterus grows elsewhere within, or even outside of, your pelvis.

The overgrowth of endometrial tissue can cause pain in your stomach, pelvis, and back during sex.

You may also experience:

Ovarian cysts

Ovarian cysts are fluid-filled pockets that develop inside or on the surface of your ovaries. They’re usually painless, but larger cysts can cause lower abdominal pain. The pain may be worse during or after sex.

You may also notice:

  • pain in your lower back or thighs
  • feeling of fullness or heaviness in your abdomen
  • bloating

Interstitial cystitis

Interstitial cystitis, also called bladder pain syndrome, can affect anyone. It causes pain and pressure in the bladder area that worsens as your bladder fills. Pain in the pelvis and lower abdomen that intensifies with intercourse is common.

You may also experience:

Fibroids

Fibroids are noncancerous growths that develop in or on your uterus. About 1 in 3 women experience symptoms from fibroids.

These include:

Uterine adhesions

Uterine adhesions, also called Asherman syndrome, refer to the formation of scar tissue in your uterus or cervix that causes them to stick together.

It’s most often caused by uterine surgery, such as dilatation and curettage, but can also be caused by C-section surgery, radiation therapy, endometriosis, or infections.

Along with lower abdominal pain during sex, you may also experience:

Sexually transmitted infections (STIs)

Many STIs, such as chlamydia and gonorrhea don’t cause symptoms. When they do cause symptoms, they vary depending on the type.

Common STI symptoms in females include:

Other infections

Other infections, which might not necessarily be transmitted sexually, can also cause lower abdominal pain when having sex. Pelvic inflammatory disease (PID) and urinary tract infections (UTIs) are the most common types.

PID is an infection of the upper genital tract that’s most common in sexually active women. It can be caused by STIs or other infections, douching, and intrauterine devices (IUDs).

The most common symptoms of PID include:

UTIs are bacterial infections that can affect any part of the urinary tract. They’re more common in females because their urethra is shorter so bacteria can get inside more easily, but males can get them, too.

Symptoms include:

  • lower abdominal pain that may intensify during sex
  • painful urination
  • frequent urination or urgency
  • cloudy or foul-smelling urine

Some causes of abdominal pain during sex are specific to the male reproductive system.

Prostatitis

Prostatitis is swelling of the prostate. The prostate is a walnut-sized muscular gland just below the bladder. It produces semen and helps propel it from the body during ejaculation.

Prostatitis can be acute or chronic. Chronic prostatitis is the most common urologic disease in men under the age of 50.

Lower abdominal pain and back pain are common symptoms. Some people also experience pain during or after ejaculation.

Other symptoms include:

  • painful urination
  • perineum pain
  • a weak urine stream
  • dripping from the penis after urination

Lower abdominal pain during sex that’s a one-off event or improves with a change of position doesn’t usually require a visit to your healthcare provider.

But if your pain is severe, happens regularly, or is accompanied by other symptoms, such as bleeding or signs of an infection, it’s best to make an appointment to determine the underlying issue.