Lower Abdominal Pain with Orgasm - Female Dysorgasmia

What to Know if You're Experiencing Lower Abdominal Pain with Orgasm

Read on for Common Causes and Solutions

Pain with orgasm or climax is called dysorgasmia, and it can be caused by physical, emotional and/ or psychological factors. Typically dysorgasmia is felt as pain with climax in or around the lower abdomen or clitoris, but symptoms can feel different from one person to the next. Due to a lack of research on female dysorgasmia, it is unknown how many vulva-owners experience pain with orgasm. However, around 3 in 4 people with a vulva have experienced pain with vaginal penetration (called dyspareunia) at some point in their life, according the American College of Obstetricians and Gynecologists (ACOG).

Physical conditions / factors that contribute to abdominal pain with orgasm are:

• Pelvic floor muscle dysfunction - During orgasm, the pelvic floor muscles contract rapidly and may cramp and possibly press on nearby nerves, causing pain. This is the most common reason for dysorgasmia and is more likely to occur in females with pelvic floor dysfunction (tight, or difficult to relax pelvic floor muscles).
• Endometriosis and uterine fibroids
• Pelvic Inflammatory Disease (PID) - an infection in the reproductive organs
• Underlying infection or diseases of the reproductive tract, bladder or urethra 

A recent case study in a 33 year old female with dysorgasmia revealed that endometriosis affecting the uterosacral ligament and endometriosis on the posterior vaginal wall contributed to dysorgasmia, which was completely resolved following laparoscopic excision surgery to remove identified lesions. Endometriosis can cause inflammation, and impact normal blood flow, muscle and nerve functioning in the abdominal and pelvic region, and can be a driver of genital and pelvic pain as well as dysorgasmia. 

Pelvic floor physical therapy has been shown to effectively improve pelvic floor muscle dysfunction (muscle tightness/ difficulty with relaxing pelvic floor muscles) through the following techniques:

• Manual therapy such as pelvic floor trigger point release, visceral mobilization, and myofascial release techniques for pelvic floor and surrounding areas like the abdomen, back, and hips
• Therapeutic movement and exercise to improve flexibility and restore optimal range of motion of the joints and muscles of the pelvis and surrounding the pelvis
• Guided muscle relaxation
• Biofeedback
• Infrared-red light therapy
• Therapeutic Ultrasound
• Self-care techniques

At Femina Physical Therapy, all of our physical therapists have specialized training to treat the underlying causes of dysorgasmia, and will work with your other healthcare providers in a collaborative manner to maximize symptom-relief and improve your quality of life. Go here to schedule an appointment today!

Resources: 

1. Female Sexual Health: Understanding Dysorgasmia. University Hospitals: https://www.uhhospitals.org/services/obgyn-womens-health/conditions-and-treatments/female-sexual-health/conditions-and-treatments/dysorgasmia. Accessed Apr 30, 2024

2. Chiminacio I, Obrzut C, Saggin S. Post-orgasm pain associated with endometriosis and complete resolution of symptoms after laparoscopic en-bloc peritonectomy, a case report. Int J Surg Case Rep. 2023;109:108558. doi:10.1016/j.ijscr.2023.108558 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10400870/ 
3. ACOG “When Sex Is Painful” https://www.acog.org/womens-health/faqs/when-sex-is-painful#:~:text=If%20you%20have%20frequent%20or,address%20problems%20with%20sexual%20response.