What causes pelvic pain after sex?
The cause is either an infection that has spread from the vagina or cervix, or a separate gynaecological or physical cause. Each leads to a different next step. The table groups the more common causes. A clinician can usually narrow it down with a few questions and, where needed, a test.
Could it be an STI, and how would I know?
Chlamydia and gonorrhoea are the two infections most likely to cause pelvic pain after sex, and both can be present without any other obvious symptom. Left untreated, either can spread upwards from the cervix and cause PID, an infection of the womb, fallopian tubes and ovaries. PID causes pelvic pain and pain during sex, and sometimes bleeding between periods, fever or feeling generally unwell.
A chlamydia test and a gonorrhoea test are £104 each, and together they're the place to start if infection is possible. Urine and swab results come back within 3 working days. If you'd like answers sooner, the FAST Screen returns all results in 6 hours. FAST Screen Simple (£350) covers HIV, syphilis, chlamydia and gonorrhoea, and FAST Screen Complex (£450) adds hepatitis B and C. Our guide to same-day results explains how it works.
What if my chlamydia and gonorrhoea test is negative but the pain continues?
Mycoplasma genitalium is a less well-known bacterium that can also cause pelvic pain, and not every basic screen includes it. Book our Mycoplasma genitalium test if a first screen has come back clear and the pain hasn't settled. It's £120.63, or £156.25 with Ureaplasma added from the same sample, with results within 3 working days. If this and an STI screen are both negative, a gynaecological cause becomes more likely and is worth assessing directly.
Could it be endometriosis or an ovarian cyst?
Some pain points more towards a gynaecological cause such as endometriosis. One is deep pain during or after sex that follows a pattern with your periods. Another is pain that has been there for months, rather than starting suddenly after a new partner or unprotected sex. A one-sided pain, especially one that came on suddenly, can suggest an ovarian cyst. Both are diagnosed through a gynaecological assessment, which may include an examination and a scan. Our colleagues at Gynae Clinic offer an initial gynaecology consultation for exactly this.
Could it just be dryness or a positional cause?
Yes. Pain concentrated at the entrance to the vagina, especially when it's worse with less lubrication, is commonly dryness rather than infection or a gynaecological condition. Pain only in certain positions, with no discharge, bleeding or fever, can be positional and often settles without a test. An infection can still sit alongside these causes, so if you're unsure, testing first is the safer choice.
When is pelvic pain after sex an emergency?
Get same-day medical assessment if you have pelvic pain after sex with a fever, severe pain, or a chance you might be pregnant. These can point to advanced PID, an ectopic pregnancy or a cyst complication. Call 999 or go to A&E if the pain is severe, or you feel faint or collapse, and call NHS 111 if you're unsure where to go. If the pain is uncomfortable but not severe, with no fever and no chance of pregnancy, a routine test is a reasonable first step.
How testing works at our Harley Street clinic
Our screening packages for women start with Bronze (chlamydia, gonorrhoea, HIV and syphilis). Silver, Gold and Platinum add Mycoplasma genitalium, Ureaplasma, Gardnerella, herpes, trichomoniasis, hepatitis and HPV. Samples are a blood test and a swab, which you can often take yourself. Results come back confidentially by phone or text. Blood tests take about 24 hours, and urine and swab results come back within 3 working days, or everything in 6 hours with a FAST Screen.
Every package includes a consultation with a doctor, and you can walk in seven days a week at 117A Harley Street. The visit is confidential, as with all our private STI testing in London.
Book a women's screening package at 117a Harley Street to test for the treatable causes of pelvic pain after sex.
References
- Pelvic inflammatory disease, NHS
- Endometriosis, NHS
- Chlamydia, NHS
- Management of pelvic inflammatory disease, BASHH
- Ovarian cysts, NHS
