Why Does My Rectum Hurt After Orgasm? (Men)

Rectal pain after orgasm is something many men experience but rarely talk about. It can be confusing, uncomfortable, and even alarming—especially when it happens without any obvious injury or infection. Some men feel a deep ache, others describe pressure or burning, and some notice pain that lingers for minutes or even hours after climax.

While this symptom is often blamed on the prostate, the cause is frequently related to pelvic floor muscle dysfunction, nerve sensitivity, and how the body handles tension during sexual activity.

What Rectal Pain After Orgasm Commonly Feels Like

Men describe this pain in different ways. It may feel like deep pressure inside the rectum, a sharp or pulling sensation, or a dull ache that gradually fades. For some, the pain is immediate and intense, while for others it builds gradually after orgasm.

In many cases, bowel movements, sitting, or even passing gas can briefly increase discomfort afterward. This is an important clue that the muscles and nerves surrounding the rectum are involved.

The Pelvic Floor’s Role in Orgasm

Orgasm involves a coordinated contraction of the pelvic floor muscles, particularly those surrounding the anus, perineum, and base of the penis. These muscles rhythmically contract to assist with ejaculation and ejaculation control.

If the pelvic floor is already tight, overactive, or poorly coordinated, these strong contractions can overload the system. Instead of relaxing after orgasm, the muscles may stay tense or spasm, creating pain deep in the rectum.

This is one of the most common reasons men experience post-orgasmic rectal pain.

Muscle Tension and Holding Patterns

Many men unknowingly hold tension in their pelvic floor throughout the day, especially those who deal with chronic stress, anxiety, low back pain, or prolonged sitting. Some also brace or clench during sexual activity without realizing it.

When orgasm occurs on top of an already tense pelvic floor, the sudden increase in muscle activity can irritate sensitive tissues and nerves, leading to pain afterward rather than relaxation.

Nerve Sensitivity and Post-Orgasm Pain

The pudendal nerve provides sensation to the rectum, perineum, and genitals. Tight pelvic floor muscles or poor pelvic mechanics can place extra pressure on this nerve. During orgasm, increased muscle contraction and blood flow can temporarily heighten nerve sensitivity.

This may explain why some men feel burning, stabbing, or electric-like pain in the rectum after ejaculation, even when everything feels normal beforehand.

The Prostate Connection (And Why It’s Often Misunderstood)

Because the prostate sits close to the rectum, post-orgasmic rectal pain is often labeled as prostatitis. While infection is possible, many men diagnosed with chronic prostatitis or chronic pelvic pain syndrome do not have an active infection.

Instead, pelvic floor muscle tension and nervous system sensitization are often the primary drivers of pain. This is why antibiotics frequently fail to resolve symptoms and why pelvic floor physical therapy plays such an important role in treatment.

Posture, Sitting, and Sexual Mechanics

Posture doesn’t just matter at a desk—it affects pelvic floor function during sex as well. Limited hip mobility, poor spinal alignment, or a tucked pelvis can increase strain through the pelvic floor during orgasm.

Men who spend long hours sitting may already have reduced pelvic mobility and increased pelvic floor tone. After orgasm, sitting down again can further compress sensitive tissues, making rectal pain more noticeable or prolonged.

Why Pain May Linger After Orgasm

Normally, pelvic floor muscles should relax after orgasm. When they don’t, pain can persist. Over time, repeated episodes of post-orgasm pain can train the nervous system to anticipate discomfort, increasing muscle guarding and sensitivity.

This can turn an occasional symptom into a recurring problem if the underlying cause isn’t addressed.

How Pelvic Floor Physical Therapy Helps

Pelvic floor physical therapy focuses on restoring normal muscle function and reducing nerve irritation. Treatment often includes assessment of pelvic floor tone and coordination, hands-on techniques to reduce muscle tension, breathing strategies to promote relaxation, postural correction, and movement retraining.

For men with post-orgasmic rectal pain, therapy aims to improve how the pelvic floor contracts and relaxes—not just during sex, but throughout daily life.

When to Seek Help

If rectal pain after orgasm happens regularly, lasts longer than a few minutes, or is accompanied by urinary symptoms, bowel changes, or pelvic pain, a pelvic floor evaluation is warranted. Pain after sex is not something men should expect or ignore.

Final Thoughts

Rectal pain after orgasm is rarely “all in your head,” and it’s often not a prostate infection. More commonly, it’s a sign that the pelvic floor is overworking, holding tension, or struggling to relax after intense activity.

With proper assessment and treatment, most men can eliminate this pain and return to comfortable, confident sexual function. 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.