Why Do My Hips Hurt After Sex?

woman lying on floor


Sex isn’t supposed to hurt, but hip problems can make some positions uncomfortable — or even painful. It’s important to talk to a doctor about any pain you have after sex.

Fluid-filled sacs (bursae) that ease friction between muscles, tendons and bones can get irritated and swollen. That can cause pain in the outside of your hip, or your groin area.

Osteoarthritis

Osteoarthritis is a joint disorder that affects the cartilage, a flexible connective tissue that protects bones in a joint. When cartilage breaks down, bones rub together, causing pain, stiffness, and swelling. The body may respond by laying down extra bone in the area, creating bony growths known as osteophytes or joint spurs. Osteoarthritis symptoms usually develop slowly. They can start in one or both joints, and the hips are often affected.

Hip replacement surgery is sometimes done to ease the pain of osteoarthritis. However, the recovery from hip surgery can take up to eight weeks, and patients will need to avoid sexual activity until their doctor gives them the go-ahead.

In some cases, sexual activity can cause hip pain in women or men who have had a hip replacement. This is because a new hip can be dislocated if it’s put under too much stress.

Getting rid of hip pain isn’t always easy, but it is possible with the right treatment and lifestyle changes. Using a heating pad or taking over-the-counter painkillers can help with the pain, as can exercising regularly and following your physical therapy plan. If the pain persists, see your doctor or ask for a referral to a physical therapist. Acupuncture is another option that many people find helpful for pain relief. It’s also important to drink plenty of water, says Lindsay Van Clief, a physical therapist and health coach.

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Bursitis

The hip joint has a bursa (plural: bursae). These are small fluid-filled sacs that act as little cushions between hard structures like bones and soft tissue like muscle. When a person has hip bursitis, they may feel intense pain when they move the affected joint. The pain can be sharp and intense at first, then become a dull ache over days or weeks. They might also feel warmth or tenderness in the area, and it might hurt to lie on the affected side.

In addition to a physical exam, doctors usually ask the patient about the symptoms and what they’ve been doing lately. They might perform an ultrasound or MRI to get better views of the hip structure and the bursae. If they think the bursa is infected, they might perform aspiration to take a sample of the fluid from the affected area. They might also prescribe antibiotics and a steroid injection to reduce the swelling.

Symptoms of bursitis include pain and tenderness, swelling, and heat or redness in the affected area. Over-the-counter pain relievers can help with the pain and lower inflammation. Some examples are aspirin, ibuprofen, or naproxen (Aleve). Using a heating pad or ice pack helps with the pain and decreases inflammation, too. People can also try alternating between cold and hot to find what works best for them.

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Sciatica

The sciatic nerve is the largest nerve in your body. It runs from your lower spine through your hips and down the back of your leg. Sciatica is pain that occurs when this nerve gets pinched or irritated. This can happen when a herniated disk or spinal stenosis presses on the nerve. It can also happen during late pregnancy as the ligaments loosen and the growing baby puts pressure on the nerve. Symptoms include a dull, aching or burning pain that travels from your lower back or buttock down one leg. You may also have numbness or a “pins and needles” feeling and muscle weakness.

The hip is a ball-and-socket joint. The “ball” is the top of your thigh bone (femoral head) and the socket is in your pelvic bone (acetabulum). Smooth, slippery tissue called cartilage lets the bones move easily against each other. A thin lining (synovium) covers the bones and joints. Muscles, tendons and ligaments make up the rest of the joint.

Your spine specialist will review your medical history and symptoms and do a physical exam. He or she will ask you to lie on your back and bend forward at the waist while keeping your feet flat on the floor. Your doctor will then raise your legs straight, noting the height at which you feel pain.

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Tendinitis

Tendinitis is a general term that describes inflammation of a tendon, which is a rope-like tissue that connects a bone to a muscle. It’s more specific than arthritis, which describes a general inflammation of a joint. Inflammation of a tendon may cause it to swell and hurt, especially during activity that puts stress on the area. In some cases, a tendon can break down and tear completely. It’s important to see a doctor if your hip pain persists. He or she may prescribe physical therapy to improve the flexibility and strength of the affected area, as well as ice packs and over-the-counter pain relievers.

The pectineus muscle is a flat, triangular-shaped muscle located deep inside the inner thigh and around the hip joint. It can cause pain if it has trigger points, which are knots in the muscle that cause the pain. If you have a trigger point in the pectineus, sitting cross-legged or lying down can make your pain worse. It might be helpful to use a pillow between your legs while you’re in bed, or lie on your side instead of on your back.

For women, pain after sex could also be caused by a condition called vulvodynia, which is painful in the vaginal opening and can last more than three months. Using extra lube and trying different sex positions can help ease this pain.

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