What causes lower abdominal pain during intercourse after having an IUD inserted?

Inserting an intrauterine device (IUD) is a form of contraception. Abdominal pain during intercourse may be caused by rough sexual activity, bacterial vaginosis, pelvic inflammatory disease (PID), cervicitis, endometriosis, or other factors.

1. Rough Sexual Activity

An IUD is a foreign body that can stimulate uterine smooth muscle contractions, leading to mild lower abdominal discomfort or bloating. If sexual activity is too vigorous, it may further irritate the area and cause abdominal pain. Usually, no specific treatment is required—simply modifying sexual practices and avoiding overly aggressive movements can help.

2. Bacterial Vaginosis

Inflammation may increase sensitivity of the vagina and cervix, making them more prone to irritation. Sexual activity may increase pressure and trigger pain, often accompanied by itching or a burning sensation. Under medical guidance, medications such as metronidazole tablets, tinidazole tablets, or clindamycin hydrochloride capsules may be prescribed to inhibit bacterial growth and control infection.

3. Pelvic Inflammatory Disease (PID)

Poor hygiene after IUD insertion may lead to PID. PID itself commonly causes abdominal pain, and intercourse may exacerbate pelvic congestion, resulting in increased lower abdominal discomfort. Additional symptoms may include vaginal bleeding, fever, and painful urination. Under a doctor’s supervision, antibiotics such as cefixime dispersible tablets, amoxicillin capsules, or cefuroxime axetil tablets may be used to treat the infection.

4. Cervicitis

An IUD is a contraceptive method placed inside the uterus. If cervical infection or inflammation is left untreated, intercourse may worsen the condition, causing lower abdominal pain. Other possible symptoms include non-menstrual bleeding, frequent urination, urgency, and dysuria. It is important to follow a doctor's advice and use antibiotics such as ceftriaxone sodium for injection, cefixime capsules, or cefozopran sodium for injection to suppress pathogen replication and promote recovery.

5. Endometriosis

In endometriosis, ectopic endometrial tissue is often located in the posterior fornix and may adhere to surrounding tissues. Movements during intercourse can stimulate these lesions, causing pain and discomfort. It is recommended to seek care from a specialist at a hospital, who may suggest semi-radical surgery or radical procedures such as hysterectomy with bilateral adnexectomy to relieve symptoms and reduce recurrence.

Maintaining good personal hygiene, especially before and after intercourse, is advised. Avoid spicy or irritating foods that might worsen symptoms. Additionally, visit a healthcare provider for evaluation, including a gynecological ultrasound, and follow medical recommendations based on test results.