Why You Might Be Experiencing Painful Sex During Pregnancy

Sex is never something you want to feel uncomfortable (that kind of defeats the whole point, right?), but it’s understandable to be worried about experiencing painful sex during pregnancy, particularly if you never had painful sex before you got pregnant. It’s not necessarily a sign of a problem—in fact, pain during sex while pregnant isn’t usually a cause for concern unless it’s accompanied by certain other symptoms—but whether it’s happening in your first, second or third trimester, painful sex still isn’t something you want to write off. Here’s what could be behind the discomfort you’re experiencing, and what to do next.

Causes of Painful Sex During Pregnancy

There are a lot of changes happening within your body right now, and some of those factors can lead to uncomfortable sex. There are also certain conditions that can lead to painful sex during pregnancy, including bladder infections, yeast infections or bacterial vaginosis, says Julie Lamppa, APRN, CNM, a certified nurse midwife at the Mayo Clinic. “All of these are more common with pregnancy because of physical and hormonal changes,” she adds.

However, the cause of the pain you experience can vary by trimester. Keep reading to figure out what could be behind your discomfort, based on your stage in pregnancy.

Painful sex during first trimester

Your first trimester, which lasts until the end of week 13, can come with unique health changes that can lead you to experience some pain during sex in early pregnancy.

• Cramping. Some women experience uterine cramping in early pregnancy, and that can lead to painful sex, says Jessica Shepherd, MD, an ob-gyn at Baylor University Medical Center in Dallas, Texas.
• Uterine growth. The initial expansion of your uterus as it makes room for your growing baby can cause painful sex during pregnancy in the first trimester, says Julie Levitt, MD, an ob-gyn with The Women’s Group of Northwestern in Chicago.
• A cyst. In some cases, a growth known as a corpus luteum cyst can take time to disappear, and while it remains it can cause pain during sex while pregnant. “It can feel like mild menstrual cramps,” Levitt says.
• A fuller-than-usual bladder. Pregnancy can make you need to use the bathroom more often than you did before, and the pressure on your bladder could feel uncomfortable during sex, Levitt says.

Painful sex during second trimester

Your second trimester runs from week 14 through the end of week 27, and can cause a new set of bodily changes that could lead to pain during sex.

• Vascular changes. “In pregnancy, hormones and an increase in blood flow can cause veins to enlarge and not function as well as they would if you weren’t pregnant,” Lamppa says. “This can cause problems with enlarged veins within the pelvis or on your vulva.” Both of these could cause painful sex during pregnancy in the second trimester.
• Pelvic congestion. Enlargement of the veins in your pelvis can cause what’s known as pelvic congestion, “which feels like heavy pressure in the vagina,” Lamppa says. It can lead to pain after sex during pregnancy and “is usually felt like a deep ache in the pelvis.”
• A yeast infection. Moms-to-be are particularly prone to yeast infections. (That’s because it’s hard for your body to keep up with all the chemical changes in the vagina, and there’s more sugar in your vaginal secretions on which yeast can feed.) Yeast infections can happen at any point in your pregnancy, but especially during the second trimester, Levitt says. “This can burn during and after intercourse,” she adds.
• Round ligament pain. Round ligaments are a pair of cord-like structures in your pelvis that help support your uterus. They connect the front of your uterus to your groin area, and they can feel uncomfortable as they stretch during pregnancy, Shepherd says–and sex can exacerbate this.

Painful sex during third trimester

During your third trimester, which begins in week 28 and lasts until you deliver, you might experience the following causes of pain during sex while pregnant:

• A heavy uterus. Your uterus stretches during your pregnancy to support your growing baby, and that can be uncomfortable as baby gets bigger. “Most of the issues with painful sex during pregnancy is just the bulk of the pregnant uterus, and indeed the way the woman is carrying,” says Mary Jane Minkin, MD, an ob-gyn at Yale New Haven Health in New Haven, Connecticut.
• Swelling. Your labia (the outer and inner “lips” of your vulva) can feel larger and your vagina can feel tighter due to swelling in your tissues, Levitt says.
• Pelvic stretching. During your third trimester, your pelvis is stretching and widening to get you ready for labor, and that can cause painful sex during pregnancy in the third trimester, Levitt says.

What to Do About Painful Sex During Pregnancy

The best remedy for painful sex during pregnancy ultimately depends on the cause of your discomfort. If it seems to be due to the size of your belly or where baby is resting, Minkin recommends taking things slow and experimenting with new moves in bed. “So much of it has to do with finding creative positions that are helpful,” she says. You can also use pillows to help ease pressure on certain areas of your body. In other cases, especially if you’re experiencing any swelling, lubricant can help ease discomfort during sex, Minkin says.

When to Call the Doctor About Painful Sex During Pregnancy

Generally, pain during sex while pregnant “isn’t concerning unless it causes significant pain, bleeding or if your pregnancy is high-rsk and pelvic rest was suggested,” Shepherd says. Still, painful sex is always worth flagging to your doctor if you can’t find a quick fix for it. You’ll want to call sooner rather than later if you have any lingering pain after sex during pregnancy that lasts more than an hour or bleeding that’s more than just spotting, Levitt says.

If you have urinary symptoms, like the urge to pee frequently or a burning feeling when you go, or if you’re experiencing unusual discharge, Lamppa recommends calling your doctor, since those could be a sign of an infection.

Of course, call your doctor if you have any questions or worries, Lamppa urges. “If you are ever concerned that what you are feeling isn’t normal or right, talk to your provider about it.”

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.