Pregnancy is a magical time, but it can also be uncomfortable in certain situations. Pain after sex is a common concern for women who are expecting, but it shouldn’t be cause for alarm.
In some cases, pelvic pain after sex may be caused by the weakened cervix or placenta previa. Other times, it could be caused by an infection or a genital issue.
During pregnancy, your body produces extra fluid to support the growing baby. This can cause the labia and vagina to feel swollen or full. It’s also common for hormone changes to increase libido and make you easily aroused. In the later stages of pregnancy, a hormone called relaxin can help prepare your pelvic muscles for childbirth. This can stretch the ligaments in your lower abdomen and cervix, making it more difficult to have a comfortable sex position.
Vaginal dryness can lead to itching, burning and irritation during sexual penetration and even pain. Using personal lubricant before and during sexual activity may help alleviate the symptoms, as can engaging in foreplay with your partner. It is important to use water-based lubricants and avoid oils, as these can damage latex condoms and diaphragms.
If you’re unable to find relief from vaginal dryness, talk to your doctor. They can recommend a moisturizing cream or vaginal gel that’s safe for use during pregnancy. They can also offer hormonal treatments to control the problem.
Reproductive hormones like estrogen and progesterone change throughout your menstrual cycle, influencing the sensitivity of your vaginal lining. You may find that sex drive increases in the days leading up to ovulation and decreases during the luteal phase, which is when the lining thickens and prepares for menstruation (4). Keeping track of your hormonal changes with a period tracking app, such as Clue, can give you more insight into the impact of your changing hormones on vaginal discomfort and sex drive.
Varicose veins occur when valves in the veins become weakened or damaged. When the veins are unable to push blood back up towards the heart, the blood pools and becomes swollen and twisted. Varicose veins may be painful, but they are usually not dangerous. Some people are more prone to developing varicose veins than others. Heredity, age and being overweight all increase the risk. Standing or sitting for prolonged periods of time can also increase the pressure on the veins and cause them to swell up.
A condition called pelvic venous congestion syndrome (PVCS) occurs when the vulva and genitals are affected by dilated and bulging veins, which cause pain in the lower abdomen and legs. It can be caused by problems with the ovarian and internal iliac veins, or by abnormal uterine bleeding. Pain tends to be unilateral and worsens with pressure, such as when women stand or have sex.
This condition is often difficult to diagnose. It is important that doctors examine the vulva and vagina both when the woman is lying down and standing. They should also do an ultrasound or magnetic resonance venography to see how the veins look without and with pressure. These tests can help to confirm the diagnosis of PVCS and find the source of the problem. If the cause is not obvious, doctors might recommend treatments such as vein embolization or sclerotherapy. These procedures involve inserting a catheter into the damaged vein to close it or injecting a chemical into the vein to block the flow of blood and reduce pain and swelling.
Pregnancy is often a time of uncertainty. You may be worried about harming your baby or feeling uncomfortable. These concerns can actually make pelvic pain more noticeable. When you feel anxious, you become more aware of every twinge of pain and that can heighten the discomfort you experience during sex. If you’re experiencing pain during sex, talk to your doctor about what could be the cause.
If your pelvic pain is intense, it might be due to varicose veins or enlarged blood vessels in your pelvic area. A growing baby can place pressure on major blood vessels in the pelvic area, aggravating existing varicose veins. In addition, swollen and enlarged vulva tissue can also contribute to painful intercourse.
Another possibility is round ligament pain. These cordlike structures inside your pelvis connect the front of your uterus to your groin and can become stretched out during pregnancy. They can also aggravate pelvic pain and back pain.
Fortunately, most cases of pelvic pain after sex are not harmful to the baby. However, it is important to communicate openly with your partner about sexual comfort and find ways to reduce discomfort, such as by trying different positions or using lubrication. In some cases, pelvic pain can be a sign of a more serious issue such as a urinary tract infection or cervical incompetence.
When your baby gains weight during pregnancy, it puts more pressure on the pelvic floor muscles, which support the uterus and vagina. This can make sex more uncomfortable for many pregnant women. It can also lead to pain in the area around the pubic bone, which some women describe as achy or like they have shaky legs.
During the third trimester, your uterus becomes quite heavy to support your growing baby. This makes it more difficult to perform sex because your pelvis is wider and your labia (the outer and inner “lips” of the vulva) may be larger due to swelling in the tissues, Levitt says.
A full bladder can also contribute to pelvic pressure during sex because it pushes on the bladder, making it harder to have an orgasm. It can also lead to urinary tract infections because of increased vaginal secretions on which yeast thrives.
Another problem during the third trimester is enlarged veins in your pelvic region caused by increased blood flow to your abdomen and pelvis. This can feel like pressure in your vagina or a deep ache, particularly after sex, Lamppa says.
Round ligament pain, which happens when the cordlike structures within your pelvis that connect the front of your uterus to your groin stretch during pregnancy, can cause severe discomfort, Shepherd says. It’s super common and not harmful to the baby but it can make sex uncomfortable in certain positions.