Painful Sex During Pregnancy – The Third Trimester

Pregnant Woman Sitting on Bathtub

Pain during sex while pregnant is not uncommon and it’s usually not a cause for concern. Several factors could be to blame.

For example, you may be suffering from round ligament pain. This happens when the ligaments that support the uterus soften and stretch during pregnancy. It can feel like a sharp pain or cramp during sex.

Hormone Changes

The third trimester marks the home stretch as your body gets ready for delivery. Your fetus grows in size and weight, while your hormones change to prepare for labor.

Your uterus also begins to thin and open (dilate) at the end of this trimester, making it easier to deliver the baby. At the same time, your sphincter muscles tighten and your nipples expand in preparation for breastfeeding. You may start having false contractions, known as Braxton Hicks contractions.

Hormone changes can cause a variety of symptoms, including tiredness, headaches, backaches, heartburn and trouble sleeping. You may also notice swelling in your legs, ankles, feet and hands. This is caused by fluid retention and slowed blood circulation. If the swelling is extreme, contact your doctor.

You may find that you feel the need to urinate more often during this time because of increased pressure on your bladder. You may also get sciatic nerve pain, which is a sharp, shooting pain that runs from your lower back to your buttocks and down your leg. This is due to a combination of hormonal changes and the pressure of your enlarged uterus on the nerves that run down your leg. You may also have restless leg syndrome, a condition that causes you to move your legs frequently. This can help to relieve the discomfort.

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There’s a chance your bump is getting in the way of some intimate moments. If this is the case, it’s totally normal and nothing to worry about. Just make sure to tell your partner and try not to be too pushy.

Another reason you might feel uncomfortable during sex is the fact that your pelvic muscles may be stretched and sensitive as the uterus grows. In addition, the round ligaments – cordlike structures that connect the front of your uterus to your groin – can start to stretch and cause pain during sexual activity. This is known as pelvic girdle pain (PGP) and it’s completely normal.

According to a study published in the journal Fertility and Sterility, PGP can be caused by increased blood flow, pressure on the bladder, and swelling. If this is the case for you, sex during pregnancy may not be very enjoyable and you might want to consider trying new positions or lubrication.

Other causes of painful sex during pregnancy include hormonal changes and an emotional response to arousal, especially for women who have experienced sexual trauma in the past. Having a conversation with your partner about how you’re feeling and what’s comfortable is also important as this could help you to find the best position to have sex in. You should always talk to your doctor if the pain becomes too much and isn’t relieved by trying different positions or using lubricant.

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Round Ligaments

Round ligament pain is the result of stretching in the abdomen that happens as your uterus expands to make room for the baby. It’s usually painless, but can feel like a dull cramp, and occurs on one or both sides of the abdominal area. It’s typically worst when you move quickly or if you laugh, sneeze or cough. These movements stretch the ligaments and pull on nerve fibers, which causes the pain.

Nonpregnant women have thick and short ligaments, which tighten and loosen slowly. During pregnancy, hormones can cause these ligaments to become long and taut. Sudden movements can also trigger a sharp pain, similar to a pulled rubber band. This is why it’s important to change positions gradually and wear a maternity support belt when you exercise.

If the pain persists, try resting with a pillow under your belly or between your knees and drawing your pelvis together to relieve tension. You can also try a gentle stretch or prenatal yoga, but be sure to talk to your doctor about what’s safe for you. If your pain doesn’t subside or is accompanied by other symptoms, such as vomiting or bleeding, contact your practitioner immediately. They may recommend acetaminophen to ease your discomfort.

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Bladder Pressure

As your pregnancy progresses, the round ligaments—a pair of cordlike structures within the pelvis that connect the front of your uterus to your groin area—can start stretching. This, combined with a larger-than-usual bladder, can cause pain during intercourse. This may feel like a stabbing internal pain or a duller, more constant ache.

You might also have a bladder infection, especially in the second trimester (weeks 14 through 27). This can hurt during sex because the bacteria in your urine can cause irritation to the vaginal tissues and cause you to pee more often, which adds pressure. It can also cause a burning sensation during sex, Levitt says.

Another possibility is a cyst, which can be painful during sex because it’s a mass that sits between the urethra and the bladder, Levitt says. It can take time to disappear after delivery, but while it’s there, it can cause pain during sex.

Overall, a little pain during sex while pregnant is not a big deal—especially if it goes away quickly. Using lubrication and trying different positions during foreplay can help, as can limiting fluids and taking it easy. But if the pain is more serious, like bleeding that lasts an hour or more or severe pain, call your doctor. You and your doctor can determine the cause of the pain and find a solution so you can have a more satisfying sex life.