Painful Sex During Pregnancy – Is It Normal?

person touching person's belly

Pregnancy brings many changes to a woman’s body, including some that make sex uncomfortable. But painful sex isn’t necessarily normal and could be a sign of a serious problem.

A few root causes include a dry vagina (from hormones or from not using enough lubricant), a fuller-than-usual bladder and round ligament pain, which occurs when the uterus stretches to prepare for birth.

1. Extra weight

A growing baby puts a lot of pressure on the pelvic bones, leading to pain during and after sexual activity. In addition, many pregnant women have vaginal dryness that leads to itching or burning during sex, which makes for uncomfortable moments.

Hormones can also change a woman’s sensations during sex, and she may experience more friction on her vulva or rectum than usual. And that’s fine, says Dr. Gelman, as long as a woman has a good supply of water-based lubricants on hand to reduce discomfort.

Another potential cause of painful sex during pregnancy second trimester is an infection, says Jimmy Belotte, an OB-GYN in the Department of Obstetrics and Gynecology at Montefiore Health System. An untreated infection like a urinary tract or yeast infection can put the baby at risk, so it’s important to get an appropriate treatment, such as a prescription-strength antibiotic. Other infections, such as a vaginal staph infection or an STI, can also interfere with sexual enjoyment and require a different treatment plan.

2. Anxiety

If your uterus is growing too big, you may feel pain in the pelvic area during and after sex. This is normal, but it can make sex uncomfortable, especially if you’re concerned that the baby is being hurt during penetration.

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In addition, the changing hormones during pregnancy can cause an increase in vaginal sensitivity and lead to itching or burning sensations. Moms-to-be are also more prone to yeast infections (yeast thrive on the sugar in your vaginal secretions) and round ligament pain, which is caused by the stretching of the round ligaments that support the uterus in the pelvic area.

Some women can experience pain during pregnancy second trimester from a clogged fallopian tube due to the swelling of the cervix. In other cases, the discomfort is due to a cyst in the pelvic region called corpus luteum that takes time to clear. Fortunately, this pain is usually short-lived. Using lubricant, trying new positions, and taking it easy can all help. Adding some pillows can also relieve pressure on the back and pelvis, Dr. Davenport says.

3. Swelling

Hormonal changes cause a lot of things in the uterus to swell and become sensitive. The nipples, breasts and vulva can go from being turn on to a pain during orgasms or sexual activity and that can take the pleasure out of sex. Talking with your partner about different positions, using a lubricant and even trying oral sex can help keep things pleasurable.

In addition to swelling, your uterus also becomes heavier as it stretches to make room for the baby. This can feel uncomfortable for some couples. Round ligament pain is another issue that can occur in between the first and third trimester. It’s caused by the stretching of the round ligament and affects 10 to 30 percent of pregnancies.

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An infection can also change the way sex feels, whether it’s a yeast infection or an infection in the genital area. If you suspect an infection, call your doctor or ob-gyn right away. They can prescribe antibiotics to treat the infection and get you back to a more pleasant place during sex. They can also give you tips to prevent future infections.

4. Pelvic congestion

This is the time when your uterus and pelvis stretch out to prepare for childbirth, which can lead to pain during sex. Sometimes the lining of your vagina will hurt, too. Both of these are totally normal.

A common problem in pregnancy is pain caused by the round ligaments—two cordlike structures within your pelvis that connect the front of your uterus to your groin. These can stretch out when you are pregnant and can feel like a deep ache or a cramp. This is known as pelvic girdle pain (PGP).

It’s important to remember that this kind of pain, which can be made worse during sex, is not a sign that the baby is coming too soon or is in danger. It’s simply a part of the experience of being pregnant.

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Often, the pain will ease when you move around or change positions, or when you use pillows to help with the pressure. Using lubricant can also help. If you can’t get the pain to go away, talk to your partner about it. You may be able to find a position that works for both of you.

5. Varicose veins

Varicose veins are swollen, twisted veins that are usually found in the legs. But pregnancy can cause them to appear in the vulva, as well. They are called vulvar varicosities, and they can be embarrassing and uncomfortable. These tangled lines usually look bruised in color and gnarled like tree roots. They occur in about 5 percent of all pregnant women, according to Dr. Roshan, and are a result of the pressure of the expanding uterus and placenta on the lower abdomen.

During pregnancy, the hormone progesterone relaxes ligaments and muscles, which makes it harder for blood to move upward through the veins. This increases the pressure on vein walls and squeezing on the valves that regulate the flow of blood.

As a result, blood pools in the lower body, which causes veins to enlarge and become twisted and bumpy. The condition is usually harmless, and the veins get better after the baby is born. To help prevent varicose veins, wear pantyhose, tights and socks that are supportive. Elevate your feet when sitting or lying down and avoid crossing your legs. Do regular Kegel exercises to strengthen the muscles in your pelvic area.