Painful sex during pregnancy is common, but not necessarily a sign of a problem. It can be caused by a number of factors and the causes can vary by trimester.
For instance, increased blood flow can cause enlarged veins in the pelvic region and vulva, causing pain during sex. Infections, like bladder infections, yeast infections and bacterial vaginosis are also more common during pregnancy.
Anxiety
The early weeks of pregnancy are an emotional time. It’s not unusual to experience anxiety, which can be triggered by feelings of fear or uncertainty about your growing baby. In some cases, anxiety can also cause a lack of sexual arousal, which results in painful intercourse. It is important to discuss this with your health care provider, and to talk about ways to manage your anxiety during this time of your life.
You may also notice that you need to urinate more frequently as your body produces extra hormones. This can be a sign of a urinary tract infection. If you are experiencing this symptom along with other symptoms of a UTI, such as pain or bleeding after urinating, contact your doctor immediately.
Depending on the source of the pain, treatment options may include pelvic floor physical therapy or other types of specialized physiotherapy, counseling or medications to address the underlying causes of your pain. In some cases, you may also be referred to a specialist sex therapist or psychologist.
Some women who have painful sex during pregnancy have a condition called vulvodynia, which is pain that affects the outer lips of your vagina (the labia majora) and the area that encloses the clitoris. This condition can be caused by physical changes, a hormonal imbalance or psychological factors. Treatment for vulvodynia can include the use of lubricants, pelvic muscle exercises and counseling to overcome the stressors that contribute to this type of sexual pain.
Weight Gain
Painful sex is often caused by not enough vaginal lubrication, a common condition known as dyspareunia. The pain may feel sharp, burning or like menstrual cramps. It can occur at entry (intromission), during, or after sexual activity. The pain can also feel deeper than normal, causing the woman to experience a sensation that something is being bumped into inside her. This type of pain is referred to as collision dyspareunia.
Other causes of painful intercourse include not enough foreplay, a drop in estrogen levels (postmenopause), physical conditions such as pelvic organ prolapse or uterine fibroids and medications, including antidepressants, high blood pressure medication, sedatives and birth control pills. Some women also report a lack of desire or arousal during sexual activities, which can lead to pain during sex.
Depending on the cause, treatment for painful sex can be as simple as using a lubricant or increased foreplay. For some women, a gynecologist will recommend pelvic floor physiotherapy or counseling to address emotional or psychological issues that might be affecting the pain. At Kernodle OB/GYN, we understand that many women are nervous about discussing these issues with their doctor. We work to ensure our patients are comfortable and confident that they can discuss any concerns with their obstetrician in an open and respectful manner. We will always help to relieve any pain and discomfort.
Infections
Besides a burgeoning bump, swollen feet, morning sickness and other pregnancy-related symptoms, painful intercourse can also be caused by an infection. If you experience pain during sex along with fever, heavy bleeding or abnormal vaginal discharge (especially if it smells bad, feels itchy or has unusual color), contact your doctor right away to discuss your symptoms and determine the best course of action.
Infections during and after sex are common in early pregnancy due to hormonal changes, according to the American College of Obstetricians and Gynecologists. These can include bladder infections, yeast infections and bacterial vaginosis. Pain during sex and lingering pain afterward are usually nothing to worry about but it’s important to speak with your doctor if you’re experiencing a fever or if the symptoms last more than an hour.
To avoid painful sex, try to relax and find positions that take pressure off the abdomen. Many women find that having sex while sitting is more comfortable than standing, especially for the first trimester. Using pillows can help reduce discomfort and lubricant can be beneficial as well. For example, if you aren’t comfortable lying on your stomach during penetration, lean on a pillow with your knees bent and ask your partner to stand behind you so their weight isn’t pressing down on the bump. This can reduce the amount of force needed for penetration and may stimulate the clitoris better.
Blood Flow
Pain during intercourse may be caused by a number of things including changes in hormones, vaginal dryness and the shifting position of the uterus. Pain is also common in women with vulvodynia, which is chronic pain or tenderness of the external sexual organs (the labia, clitoris and vagina).
If pain occurs during sex, it’s important to talk to your healthcare provider about it. They can help you determine the underlying cause and give you advice or treatment options to make sex more comfortable.
Some pregnant women have spotting or light bleeding during the first trimester. This is normal and most often not a concern. The most likely cause of this type of bleeding is the cervix, which becomes sensitive during pregnancy. The doctor will likely check your cervix with a speculum and may order an ultrasound or other tests.
Other women have pain during sex because of deep penetration (collision dyspareunia). This is usually related to a medical condition or surgery and can be resolved by using lubrication, changing positions or having sex more frequently.
Women are often reluctant to discuss painful sex with their partners or their doctors, and this can lead to complications in the relationship. But talking openly about it is vital for the health of both the mother and the baby. A good gynecologist is the best place to start, as they’re familiar with these issues and can diagnose problems quickly.
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