Pain After Sex in Men: What It Means and How to Fix It

Pain after sex isn’t something most men feel comfortable talking about—but it’s more common than you think. Whether it’s a burning sensation after ejaculation, a deep ache in the perineum, or pain in the penis or testicles, these symptoms are signs that your body is trying to tell you something. Ignoring them can allow the issue to worsen, but the good news is that most causes are highly treatable, especially with pelvic floor physical therapy.

Common Types of Pain After Sex

Men can experience discomfort in several different areas after sexual activity. Pain might be located in:

• The penis (sharp, burning, or aching)

• The testicles or scrotum

• The perineum (the area between the scrotum and anus)

• The lower abdomen, bladder region, or inner thighs
  Some men even describe a deep pelvic ache or pressure that lingers for hours or days after intercourse.

Why Does Pain Happen After Sex?

Pain after sex can come from several overlapping systems—muscular, nervous, urologic, or even emotional. Here are the most common underlying reasons:

1. Pelvic Floor Muscle Dysfunction

Your pelvic floor muscles contract during orgasm and ejaculation. If those muscles are already tight or overactive, that contraction can trigger cramping, nerve compression, or a “post-ejaculatory ache.” Chronic tension in these muscles can also restrict blood flow, irritate nerves, and make it painful to urinate or sit afterward.

Pelvic floor therapy helps by teaching you to release these muscles, improve circulation, and restore healthy coordination during arousal and climax.

2. Prostatitis or Pelvic Inflammation

Prostatitis—especially the chronic, nonbacterial type—is one of the most common causes of post-sex pain in men. The prostate sits right in front of the rectum and is surrounded by pelvic muscles, so inflammation here can radiate to the perineum, lower back, or genitals. Even when infection isn’t present, pelvic floor therapy can reduce muscular tension and improve drainage from the prostate region.

3. Nerve Irritation or Entrapment

Nerves like the pudendal nerve, genitofemoral nerve, or ilioinguinal nerve supply sensation to the penis, scrotum, and perineum. If these nerves are irritated by tight muscles, scar tissue (from hernia surgery or cycling), or pelvic misalignment, they can send pain signals after sexual activity. Releasing tension in surrounding fascial and muscular structures helps take pressure off these nerves.

4. Pelvic Misalignment and Posture

Postural problems—especially from prolonged sitting—can tilt the pelvis forward, shorten the hip flexors, and increase pressure on the pelvic floor. Over time, this poor alignment can cause muscle overactivity and strain during sex. Addressing core and hip stability can be just as important as working on the pelvic floor itself.

5. Emotional and Nervous System Stress

Chronic stress and anxiety activate the sympathetic nervous system (“fight or flight”), which causes involuntary tightening of the pelvic muscles. This creates a feedback loop: the more pain and anxiety you feel, the tighter the muscles get. Pelvic floor therapy combined with breathwork and relaxation retraining helps shift the body into a calmer parasympathetic state.

How Pelvic Floor Therapy Can Help

Pelvic floor physical therapy looks beyond the surface symptoms to uncover the mechanical and neuromuscular contributors to your pain. Treatment may include:

• Manual release of tight pelvic muscles (both external and internal)

• Fascial counterstrain to reduce tension and improve blood and lymph flow

• Nerve mobilization techniques for pudendal or genitofemoral irritation

• Diaphragm and breathing retraining to calm the nervous system

• Postural correction and hip mobility exercises

The goal is not only to eliminate pain but also to restore normal muscle function, improve erection and ejaculation comfort, and rebuild confidence in sexual activity.

When to Get Help

If you have persistent or recurring pain after sex—especially if it’s accompanied by urinary symptoms, testicular pain, or pelvic tightness—it’s important to seek professional help. Your doctor may rule out infection or structural issues first. Then, a pelvic floor physical therapist can assess the muscular and fascial components that often go overlooked.

The Bottom Line

Pain after sex is not “in your head,” and it’s not something you just have to live with. Most of the time, it’s a signal from your pelvic floor and nervous system that something is out of balance. Addressing those underlying issues through pelvic floor therapy, posture correction, and stress regulation can completely change how your body feels and functions.

Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at receptionmadison@pelvichealthnj.com.