Hip pain during sex is more common than people think, but those who suffer are often uncomfortable telling their providers, said Elizabeth Scott, MD, a hip specialist and orthopaedic surgeon at Duke Health. In many cases, hip impingement or a labral tear is the culprit. Dr. Scott advises people who experience hip pain during sex to speak up. “If you're feeling it, talk to someone because it's not normal to have hip pain with sex.”
Here, Dr. Scott answers questions about what causes hip pain during and after intercourse and how to get relief.
Why do my hips hurt during and after sex?
There are several possible sources of hip pain during sex. One of the most common is hip impingement -- when the top of the thigh bone and the hip socket don't fit together properly. Another is labral tears, which occur when the tissue that holds the ball and socket together is injured. Although labral tears can occur alone, they often result from hip impingement. When someone with these issues flexes their hips, pain can occur in the moment or hours later, said Dr. Scott.
Who suffers most from hip pain during sex?
Since position matters more than gender, anyone with hip impingement or labral tears can be affected. Lying face up, flexing the hips, and abduction -- moving the leg away from the midline of the body -- can aggravate the problem.
If my hips hurt during sex, will I need surgery?
Not necessarily, said Dr. Scott. “We always start with conservative treatments.” Physical therapy and specific strengthening exercises can stabilize the hips. Physical therapists can give advice about which sexual positions to avoid because they force hip flexion. Combining anti-inflammatory medications like ibuprofen with physical therapy may provide enough pain relief, she said.
If these treatments do not help, the next option is steroid injections. “For some people, that's enough, but if injections don’t work or wear off quickly, that’s when we talk about surgery,” she explained. The most common surgical treatment is a type of hip preservation surgery called hip arthroscopy. Underlying structural problems are corrected and labral tears are repaired during this minimally invasive procedure.
What are other warning signs of hip impingement?
Common symptoms of hip impingement and labral tears include pain after sitting or driving for long periods. It may also hurt to bend over or to participate in sports or other activities.
What if something other than hip impingement is causing my hip pain?
Dr. Scott recommends seeing a hip specialist to determine the precise cause of pain during intercourse. She and her colleagues diagnose hip impingement and labral tears by discussing symptoms, conducting a physical exam, and performing imaging tests like X-rays and MRIs. “If it looks like something else, I can refer patients to another specialist,” she said. For example, she might send someone with possible pelvic floor dysfunction to an ob-gyn provider.