Kidney stones are hard, crystal-like deposits that form within the urinary tract, most commonly causing intense pain in the flank or back. This condition is medically known as nephrolithiasis, and its primary symptom, renal colic, is one of the most severe forms of pain a person can experience. While the pain is typically associated with the back and abdomen, a lesser-known symptom is dyspareunia, or painful sexual intercourse. This article explores how a kidney stone can lead to discomfort during sex, explaining the underlying anatomical connections and steps for diagnosis and relief.
Kidney Stones and Painful Intercourse
The connection between a kidney stone and painful intercourse stems from the stone’s physical location and the irritation it causes. A stone lodged in the lower section of the ureter—the tube carrying urine to the bladder—can lie in close proximity to the pelvic organs. This area, known as the distal ureter, is situated near the reproductive organs and their nerves.
Physical movement during sexual activity, particularly deep penetration, can place mechanical pressure on the inflamed ureter containing the stone. This compression triggers an intense pain response. The stone causes inflammation and muscle spasms in the ureter wall, making the structure hypersensitive to external force.
For individuals with female anatomy, the ureter passes close to the vagina and uterus, allowing deep penetration to directly impact the inflamed tissue. For individuals with male anatomy, the radiating pain from a distal ureteral stone is often felt in the testicles or groin, and the physical exertion of sex can exacerbate this discomfort. Resolving the stone is the only way to eliminate this mechanical source of pain.
Understanding Nerve Communication and Referred Pain
The phenomenon of experiencing pain in the groin or during sex when the problem originates in the kidney is explained by referred pain. The kidneys and ureters share nerve pathways with the reproductive organs and the skin of the groin and inner thigh. Sensory signals from the upper urinary tract travel through nerves that enter the spinal cord primarily at the T11 to L2 segments.
The brain interprets sensory input arriving at these shared spinal segments as originating from the largest source area. Since nerves from the ureter, groin, and genitals converge here, the brain mistakenly attributes the intense pain signal from the irritated ureter to the groin or genital region. This explains why pain from a stone can be felt in the labia or testicles.
When the stone is lodged low in the ureter, the pain signals also distribute through nerves that supply the pelvic area, such as the genitofemoral and ilioinguinal nerves. This neural crossover confuses the pain location, causing the discomfort to manifest as deep pelvic or genital pain. The resulting pain during intercourse is a neurological misinterpretation of the true source: the stone physically irritating the ureter.
Recognizing Other Common Kidney Stone Symptoms
While painful sex is an atypical symptom, it is usually accompanied by more classic signs of a kidney stone. The most prominent symptom is renal colic, characterized by sudden, sharp, and severe pain in the side and back, often located below the ribs. This intense pain typically moves downward toward the lower abdomen and groin as the stone progresses.
Other common symptoms include:
- Nausea and vomiting, often triggered by shared nerve pathways between the urinary tract and the gastrointestinal system.
- Hematuria (blood in the urine), which may be visible as pink, red, or brown, or only detectable microscopically.
- Changes in urination patterns, such as a persistent, urgent need to urinate, or a burning sensation during urination, especially when the stone is near the bladder.
The presence of fever and chills alongside any of these symptoms is a warning sign of a severe infection and requires immediate medical attention.
Diagnosis and Treatment Options
If a kidney stone is suspected as the cause of painful intercourse, the first step is to consult a physician, often a urologist. Diagnosis begins with a urinalysis to check for blood, infection, and crystals characteristic of stone formation, followed by blood tests to evaluate kidney function.
Imaging studies are essential for a definitive diagnosis. A non-contrast computed tomography (CT) scan is the gold standard for visualizing stones within the urinary tract, though an ultrasound or X-ray may also be used. Once the stone is identified, treatment focuses on either natural passage or intervention.
Conservative Management
Smaller stones, generally less than 5 millimeters, are managed conservatively by encouraging high fluid intake and prescribing pain medication. Medications known as alpha-blockers may also be used to help relax the ureter muscles, facilitating the stone’s passage.
Interventional Procedures
For larger stones, or those causing persistent pain or obstruction, interventional procedures are necessary. Shock wave lithotripsy (SWL) uses focused sound waves to break the stone into smaller fragments that can be passed in the urine. Alternatively, a ureteroscopy involves passing a thin, lighted scope through the urethra and bladder to the ureter to either retrieve the stone or break it up with a laser. Removing the underlying stone is the most effective treatment for resolving the associated dyspareunia.