Q: I am a 25-year-old female and I hope you can enlighten me. I often experience pain after orgasm. It feels as though my uterus and anus tighten (I’ve never had anal intercourse). It doesn’t happen every time, but more often than not. It’s extremely uncomfortable, and it takes roughly 10 minutes or so for the pain to subside. Other than that, everything is fine. This is normal for me, as it’s happened ever since I became sexually active. 

A: Spasm of the muscles of the pelvic floor sometimes occurs during or after intercourse, especially if orgasm may not have occurred. Since the pelvic floor muscles enwrap both the vagina and rectum, discomfort in both areas may be possible. Remedies must be individualized. If failure to climax is related, this should be addressed. Hormonal levels, especially testosterone may also be of value. As a nonspecific remedy, application of heat to the lower abdomen may be helpful.