Orgasm Shouldn’t Be Painful — Here’s How to Find Relief

“No, it’s not normal or healthy to be experiencing painful orgasms,” says pelvic floor therapist Julie Gillespie PT, DPT, OCS, with Gillespie Physical Therapy in Los Angeles, California.

But, dysorgasmia isn’t as uncommon as the dearth of research and information on it might have you believe.

At this time, there isn’t any conclusive data on what percent of people experience painful orgasm.

But Michael Ingber, MD, board certified urologist and female pelvic medicine specialist with The Center for Specialized Women’s Health in New Jersey, suspects around 10 percent of people experience this at some point in their lifetime.

That said, painful orgasms aren’t something you need to suck up and deal with. “There are remedies for painful orgasms,” says Gillespie.

There’s about as many things that can cause someone to orgasm as there are things that can cause an orgasm to be painful.

This includes physical, emotional, mental, and psychological factors — sometimes a combination of two or more.

For example, as Angela Jones, OB-GYN and resident sexual health advisor at astroglide explains, pelvic floor muscle dysfunction is one of the main causes of painful orgasms.

Just as someone can hold stress in other muscles — think: shoulders, neck, lower back — it’s very possible for someone to hold stress and tension in the pelvic floor muscles.

So while pelvic floor dysfunction is a real physical experience, sometimes the original cause of dysorgasmia is a history of chronic stress, or emotional or sexual trauma.

If someone grew up in a sex-negative household or community, pain with orgasm could also be linked to internalized shame around:

• masturbation
• partnered sex
• premarital sex
• sexual orientation

Hey, vulva owners! Ever experience pain with internal (vaginal) or external (vulvar) stimulation? Here are some common causes and solutions:

What are some of the more common causes?

As Angela says, “The list of things that cause painful orgasms really goes on and on.” Below are just a few of them.

Pelvic floor over-reactivity

In vulva owners, the most common cause of dysorgasmia is pelvic floor dysfunction.

As a refresher: the pelvic floor muscles are located in the — you guessed it! — pelvis. They span from the pubic bone (in the front) to the coccyx (in the back) and from side to side.

They hold the pelvic floor organs — uterus, bladder, and bowels — in place.

During orgasm, these muscles contract really fast. Sometimes pain during orgasm happens because these muscles cramp.

“Sometimes, in patients with already tight, tense pelvic floor muscles, orgasm causes these muscles to become even tighter, which is painful,” says Ingber.

Other times, Heather Jeffcoat, DPT, who specializes in sexual dysfunction, pain, and incontinence, and author of “Sex Without Pain: A Self-Treatment Guide to the Sex Life You Deserve” says, “The muscle contractions can result in nerve impingement, which leads to pain during orgasm.” Ouch.

Endometriosis

Endometriosis occurs when uterine tissue grows outside the uterus. Pelvic pain is one of the most common symptoms, with pain during sex or orgasm not too far behind.

If you have endometriosis, you may also experience:

• painful bowel movements or urination
• painful, heavy periods
• lower back pain

Pelvic inflammatory disease (PID)

PID is an inflammatory infection in the reproductive organs. It usually occurs when an untreated sexually transmitted infection (STI) spreads to the uterus, fallopian tubes, or ovaries.

PID can also cause:

• bleeding during sex
• spotting between sex
• fever
• change in discharge, odor, or taste

The longer it’s left untreated, the more likely it is to cause complications. Catch it early enough and a course of antibiotics should clear it right up.

Ovarian cysts

Ovarian cysts are fluid-filled pockets that can occur in or on the ovaries, which can cause pain during penetration — especially deep penetration.

They typically go away on their own within a few months.

Uterine fibroids

Uterine fibroids don’t always cause symptoms.

But in some cases, penetration can cause an onset of pain, constipation, or lower back soreness.

History of painful orgasms

Sometimes people will experience pain during orgasms even after the initial cause has been remedied.

“When there is an expectation of pain, the physical result will be more pain because your muscles will guard in anticipation of that pain,” explains Jeffcoat. “Sometimes the pain becomes a self-fulfilling prophecy.”

Undoing this requires retraining the body and brain to see orgasm as pleasurable, instead of painful.

Is there anything you can do on your own to find relief?

Sex isn’t supposed to hurt. And if the sex you want to be having is causing you pain, you reallyyy shouldn’t be trying to troubleshoot the pain on your own.

Odds are there’s an underlying condition that needs treatment. Delaying seeking expert advice could exacerbate your symptoms or lead to other complications.

Besides, seeking expert advice could absolve your painful orgasms altogether.

The following are five common causes for painful penile orgasms:

What are some of the more common causes?

There’s a wide, wide range of conditions that can cause painful ejaculation in folks with penises.

Untreated STI

Experiencing burning, irritation, or stinging during ejaculation? It could be an untreated STI.

This is a common symptom of bacterial STIs, including:

• gonorrhea
• chlamydia
• trichomoniasis

All bacterial STIs are completely curable with the right antibiotics, and all viral STIs, such as herpes, can be managed.

Pelvic floor dysfunction

“Penis-havers have the same pelvic floor musculature that vagina owners do,” explains Ingber.

“So during orgasm, when ejaculation occurs, there is rhythmic contraction of the pelvic floor muscles that can cause pain and, in some cases, nerve impingement,” he says.

Prostatitis

The prostate is a quarter-sized gland located below the bladder, toward the penis in people assigned male at birth.

Sometimes, this gland becomes inflamed due to bacteria, infection, or a chronic condition. This is known as prostatitis and it can make ejaculation painful.

Prostate cancer

The prostate can also become a site of cancer.

Prostate cancer is often asymptomatic, but when there are symptoms, painful ejaculation is common.

Worth mentioning: Some penis owners experience painful orgasm after getting radical prostatectomy or undergoing radiation therapy, two common treatments for prostate cancer.

Ejaculatory cysts or stones

Yup. It’s possible for one of these to develop in the ejaculatory duct (aka where semen comes out). And if the duct is blocked? Ouch!

Is there anything you can do on your own to find relief?

Please, if penile orgasm is causing you pain rather than pleasure, talk to a healthcare provider.

Given that cancer is one of the possible causes, this kind of pain isn’t something you should ignore or try to treat on your own. K?

As a refresher, an anal orgasm can occur after any kind of anal stimulation — be it licking, plugging, penetrating, massaging, or fingering. And, like other orgasms, it’s supposed to be pleasurable!

What are some of the more common causes?

Below are the two most common reasons that anal orgasms are painful, even when the anal stimulation was the exact opposite.

Again for the people in the back: Anal sex isn’t supposed to be painful.

Pelvic floor overactivity

Remember how above we said the pelvic floor muscles span around to the back of the pelvis? Welp, sometimes those pelvic floor muscles cramp around the anal canal.

The result equals pain during anal orgasm.

FYI, the official medical term for this is proctalgia fugax.

Nerve impingement

Just as pelvic floor overactivity can cause nerve damage in the vagina, it can also cause it in the anus.

“There is a branch of the pudendal nerve called the inferior rectal branch,” explains Jeffcoat. “If there’s an entrapment or impingement of the pudendal nerve, it can create pain during anal orgasm.”

Is there anything you can do on your own to find relief?

On your own? No.

With the help of a pelvic floor therapist, proctologist, or OB-GYN? Heck yes!

Gillespie notes that in her experience, people are less likely to come forward about pain during orgasm resulting from anal intercourse. But she says that shouldn’t be the case!

“Pelvic floor therapists and experts are here to help you, not judge you,” she says. (We love to hear it!)

Does one painful orgasm warrant a trip to the doctor? Jeffcoat says no.

“If your knee hurts for one or two days, you wouldn’t immediately call up an orthopedic specialist,” she says. “This is similar.”

A one-time painful orgasm likely isn’t indicative of a larger issue.

However — and this is important! — “If you experience a second painful orgasm, even if it’s a month later, you should make an appointment,” says Jeffcoat. “That’s a sign something is brewing, and you should get evaluated before it gets worse.”

Your first step is a gynecologist or primary care provider. They’ll be able to determine if the pain is the result of any underlying infection or disease.

If it’s not, the next step is to see a pelvic floor therapist. Ideally, one who specializes in sexual dysfunction, endometriosis, and pain.

Jeffcoat recommends going to pelvicpain.org to find a provider. “Most on the list have advanced training in treatment for this type of pain.”

If you don’t have a pelvic floor issue, they’ll likely recommend you work with a sex therapist or somatic sex expert.

Painful orgasms are no fun. But they are treatable, so long as you seek out the right care.

Remember: You (yes, you!) deserve a sex life that’s full of pleasure.

Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.