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Why Do My Hips Hurt After Sex?

Hip pain can make sexual intimacy difficult, especially during the recovery period after hip replacement surgery. Supporting the operated leg with pillows or rolled towels can reduce pain and allow for safe positions.

Tight hips can also interfere with orgasms. The fluid-filled sacs, or bursae, that ease friction between muscle, tendons, and bones can become irritated and swollen.

Causes

Pain in the hips before or during sex is common, and there are many causes. It can be caused by rough sex, not using enough lubricant or a medical condition like endometriosis or vulvodynia. It may also be a result of an infection like a yeast or UTI, or a sexually transmitted disease like chlamydia or gonorrhea. It can even be a sign of pelvic inflammatory disease (PID).

A labral tear is a common cause of hip pain during sex. This is a problem that occurs when the cartilage in the hip socket is damaged, usually because of repeated movements from activities like dancing, long periods of sitting, or sports with repetitive motions. This can lead to a pinched nerve (the sciatic nerve) which can feel like a burning or sharp pain that radiates from the back of your hip down your leg.

Other causes of hip pain during sex include poor sex technique, lack of foreplay and not using enough lubrication, or having different-length legs or a small hemipelvis that puts pressure on your hip sockets. It can also be a result of sex positions that put pressure on the vaginal area and cause friction. A doctor can help you figure out the cause of your hip pain and prescribe treatment, such as using a heat or cold pack, taking over-the-counter anti-inflammatories, icing the painful area, and avoiding repetitive movement.

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Treatment

In a healthy hip, the ball at the top of your thighbone (femoral head) glides smoothly into the socket in your pelvic bone (acetabulum). A thin lining (synovium) covers the cartilage and makes a small amount of fluid (synovial fluid), which eases friction between bones and other tissue. Ligaments and tendons complete the joint.

When labral tears cause hip pain, it can affect the way you move in the bedroom and other activities. Sexual activity often involves deep flexion and rotation of the hips, which can trigger pain in people with this condition.

If sex hurts when you have it, talk to your doctor. It’s not normal to experience pain during or after sex, and it can lead to problems in your relationship.

Some STDs, including gonorrhea, chlamydia, mycoplasma, and trichomoniasis, can lead to painful intercourse or vaginal pain. Your doctor can prescribe antibiotics to treat the infection and relieve symptoms. Pelvic inflammatory disease, which is caused by an overgrowth of bacteria in the uterus, tubal, and ovarian lining, can also cause pelvic pain after sex. Your doctor can prescribe an anti-inflammatory medication or recommend pelvic manual therapy to help. You may also need to use extra lubricant to prevent friction.

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Prevention

It may seem unfair that sex should hurt, especially since it’s supposed to be a sensual experience. But painful intercourse is not uncommon and can stem from a number of issues, including hormonal changes, various medical or nerve conditions, and even emotional problems like anxiety or depression.

The pelvic bones—the sacrum (bottom of the spine), coccyx (tailbone), and hip bones—form a “cage” that houses muscles, connective tissue, and nerves. If these bones are out of alignment, it can throw off the muscles and tissues around the area and cause pain, particularly during sexual activity.

A hip labrum tear is one example of this. The labrum is a ring of cartilage that stabilizes the hip joint and helps absorb shock from vigorous activities like running or jumping. When the labrum tears, it can cause groin or front-of-hip pain, particularly during sexual activity.

To reduce hip and vulva pain, try to have sex when you’re feeling relaxed and use a lot of lubricant. You can also buy a sex aid that acts like estrogen and makes the vaginal tissues more dense and less sensitive, which could help alleviate pain. If you’re dealing with an existing hip problem, your orthopedist may recommend a physical therapy regimen and exercises to help relieve the pain. Or you might be prescribed a non-steroidal anti-inflammatory medication like ibuprofen to ease the pain.

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Recovery

Hip pain can be disabling, and it’s no surprise that people with hip pain don’t want to have sex. But sex doesn’t have to be off the table, even for women and men who have had hip replacement surgery. Talk to your doctor before surgery about how to have sex comfortably with a new hip. You should also ask about it at your six-week postoperative appointment. You may need to use pillows for support in your bed and take it easy until you have more strength and endurance.

If your hip hurts during sex, try using more lube. You might also want to talk with your partner about which positions feel better for both of you. And if your hip pain isn’t relieved with these home treatments, make an appointment with your doctor. Your doctor might recommend physical therapy to strengthen the muscles and tendons around your hip joint.

Your doctor might also prescribe ice or a heating pad to ease the pain and inflammation in your hips. And if your pain is severe, or you have other symptoms like fever, chills, and red skin on your hip, go to the emergency room right away. These are signs of an infection or serious injury. A doctor can treat these problems and get you feeling better faster.