Aunt Vadge: back and abdominal pain, bloating, gas, after first-time sex

Hi Aunt Vadge, 

I am 18 years old and recently new to having sex. Despite this, I am on birth control and have been for the past two years. I had sex two days ago and have been experiencing bloating, gassiness and mild abdominal pain. Recently, I have also been experiencing mild lower back pain. After we had sex, I had some minor vaginal bleeding… could that mean he broke my hymen? I have never had bloating like this before, only slight bloating during the first few days of my period, but my period is not due for another two weeks. 

I am very confused and scared.

Any information to help clear up the problem would be greatly appreciated!

Thanks.
Perplexed
Age: 18
Country: Canada

Dear Perplexed,

Mild lower back pain, abdominal pain, and intestinal discomfort can definitely be linked together, since the nerves, which are close to each other, can fire up and cause issues that appear unrelated. For example, you can relate the way period pain can cause lower back pain, and even nerve pain down the legs and in the vulva – the inflamed uterus is attached to the ‘apron’ of flesh that holds all of our organs in place, and this pulls on the lower back tissue, inflaming everything around it.

This can also contribute to intestinal disturbances, which many women report near to their periods (diarrhoea, bloating). Local inflammation of nerves and tissue have a greater impact on tissue besides the tissue that the nerve belongs to.

What is in question is whether this has to do with your sexual activity, or if it is a coincidence.

Food

First, I’d be looking at what you’ve been eating differently, and if nothing has changed that you can think of, next, I’d be looking at your vagina and other pelvic structures in more detail.

Cervicitis, pelvic inflammatory disease (PID), infection

What I would be looking for are signs of infection and inflammation (bright white or unusual discharge), pain where your cervix/uterus is, and any other signs like feeling a bit unwell. If you used a condom, we can be reasonably reassured that it is not a sexually transmitted infection, though that is still possible. STIs would usually take a bit longer to show symptoms, however, so it’s not that likely to be the culprit, even without condom use. If you can rule that out, we can move on.

Abdominal pain needs to be pinpointed to a specific area – is it coming from your intestines, or from your reproductive organs? It’s important to know the difference, though it can be really hard to tell by yourself.

Is your back out?

It could be skeletal – for example if your back is out or recently strained in some way, your nerves could be being pressed on by a bone or other structure, and be causing inflammation of nerves and nearby tissues. Do some stretches, and see if you can move and relieve the pain, or if it remains steadfast no matter what position you are in. If it’s possible that you are experiencing back pain due to a structural issue, see an osteopath. They can also help to determine the cause of your problem if there doesn’t seem to be anything obviously wrong after a visit to your doctor.

The spine and the gut are absolutely connected, and affect each other in endless ways.

Being examined

Have you ever been examined vaginally? It can really pay to start your relationship with your vag doctor early on,especially once you have started having sex, since now you are going to need to start getting pap tests every year or so. It’s really important to get the icky weird bit out of the way (having someone inspecting your junk can be pretty disconcerting!) but you need to feel comfortable getting examined, since your journey into your vagina has now begun. Sex, infections, periods, pregnancy, birth control, cancer checks, and STI checks are all now going to be part of your life ongoing.

If your symptoms don’t go away by themselves, or if more sex causes the same symptoms to return, I would recommend you go and be examined, just to make sure your vagina looks completely normal, and you don’t have any signs of inflammation or infection, or in fact any anatomical abnormalities that have so far remained undetected. It’s possible that if you have something unusual going on inside your body, it could have been poked or prodded during sex, and have caused inflammation, which could have triggered off the back pain and gut inflammation.

Don’t panic though – best case scenario is your vagina is completely normal and healthy, your bleeding was from a small sex wound, and you have just got a belly ache because you ate something that didn’t agree with you.

Easing your intestines in the meantime

To help ease your gut problems, try drinking some really strong peppermint tea – it opens up the sphincters in your intestines and promotes movement of air and intestines outwards, while also calming tissue down. I would also be carefully looking at what you have been eating – has something changed lately? Did you eat something that perhaps hasn’t agreed with you? Are your symptoms subsiding or staying steady?

Think about what you have been doing differently – besides sex – and look for some triggers there. It is highly irregular that having sex for the first time causes back pain and a stomach ache.

The vaginal bleeding

Minor vaginal bleeding after first-time sex is not unusual, and could have come from either damage to tissues or from damage to the hymen, which may still have existed in some form. Read about hymens to get more information about it – the hymen is really near the entrance to the vagina, so if you had ever used tampons, masturbated, or participated in certain types of sports (gymnastics, horse riding, bicycle riding), your hymen may not have been present. Either way, neither of those things are anything to worry about by themselves.

If the bleeding is related to the back pain, you need to know about it, since it could be related to an infection or inflammation.

My next set of steps would be:
  1. Write a list of your symptoms, any painful areas, and try to narrow down what you think is the source of the problem.
  2. Think about any foods you’ve eaten just prior to the gut issues starting.
  3. Drink some really strong peppermint tea! If you can’t find some loose leaves, get about five or six bags of regular peppermint tea from the supermarket and soak the bags for about ten minutes. It’s quite strong, but drink one cup of very strong peppermint tea to help ease your tummy a bit. You should see results as it goes through your digestive system, so within about 15-20 minutes.
  4. Check your own vagina out with a mirror. See if you can poke your fingers inside, feel around (use some vegetable oil to lube it up a bit) and find any sore bits. Write them down and draw a picture.
  5. Check your own abdomen out by lying on your back and gently pushing into your abdomen. You’ll feel where trapped gas is, but check lower, where your uterus, ovaries and fallopian tubes are. See if anything feels tender. Write it down and add it to your diagram.
  6. If the problem isn’t resolving, or recurs with sexual activity, please go and get examined by a doctor as soon as possible. It doesn’t sound like anything serious, but it does seem unusual. If you are bleeding, start to feel ill (fever, headache), or pain is increasing, please see someone.
  7. Don’t panic. Your body is simply telling you something, and it’s your job to figure out what. It could pay to talk to your doctor anyway (or visit a drop-in sexual health clinic nearby) to put your mind at ease. It’s important that you learn about your body, because you can be a 100 per cent sure that this is not the last thing that will ever go wrong with your vagina, reproductive system, or body! Knowing what is inside of you can make it easier to figure out what’s happening faster.

Write back anytime.

Warmest regards,
Aunt Vadge

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.
Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

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