Having sex is an entirely different experience when pregnant. Some claim that heightened sensitivity leads to better-than-ever orgasms, while others complain about discomfort ranging from cramping to searing stabs. Painful sex during pregnancy has a host of different causes—some normal and some worrisome—so it's important to talk to your prenatal care provider about what you're experiencing.
Here are five common reasons for painful sex during pregnancy, with tips on how to make sex while expecting enjoyable again.
1. Your Body Is Changing
Your belly isn't the only thing that changes during pregnancy. Tender nipples, swollen legs and feet, uterine cramping, pelvic pain, and other annoying (but normal) pregnancy symptoms can make sex feel unpleasant—or even downright painful.
To avoid discomfort, “partners need to communicate to find the best positions,” says Mary Jane Minkin, MD, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine. For example, side-lying can take the pressure off your growing stomach and work for everything from masturbation to oral sex to penis-in-vagina sex. Using lubrication might also be helpful—particularly for penetrative sex.
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2. You Have More Blood
During pregnancy, your vagina may become swollen, thanks to increased blood flow to support the growing uterus, fetus, and placenta. That's a lot of blood! This increase in blood volume can leave you feeling pressure down there, which can either enhance sexual pleasure or lead to discomfort.
The increased blood volume can also put pressure on the vascular system leading to vulvar varicosities or vaginal varicose veins. This condition affects 18% to 22% of pregnant people, and when it occurs, it typically begins around month five.
Luckily, in most cases, pain during sex that is caused by increased blood volume will resolve a few weeks after delivery.
3. Your Vagina Is Dry
Dr. Belotte says that vaginal dryness is rare during pregnancy, but when it occurs, it may create uncomfortable friction during penetrative sex whether it's with a toy, fingers, or penis. One reason vaginal dryness can happen during pregnancy is related to estrogen levels. Estrogen is the hormone that helps keep the vaginal canal lubricated, but if levels fall, it can lead to vaginal dryness that can irritate the skin and make some types of sex painful.
According to the American College of Obstetricians and Gynecologists (ACOG), there are a few other possible causes of vaginal dryness including:
Dehydration: Being dehydrated can accelerate all-over dryness, including in and around the vagina.Certain medications: Some studies suggest that antidepressants and cold and allergy medications may cause vaginal dryness.Certain health conditions: Autoimmune diseases such as Sjögren syndrome may also lead to vaginal dryness.
To solve the problem of vaginal dryness, try using a water-based lubricant and talk to a health care provider about what may be the root cause of your dryness, including hormone levels, medication safety, and any other health concerns you may have.
4. You Have an Infection
In some cases, painful sex during pregnancy could be a symptom of certain vaginal infections, like cervicitis, vaginitis, and chorioamnionitis, says Jimmy Belotte, an OB-GYN and Medical Director for Niraparib Ovarian in Waltham, Massachusetts. You may also have a pelvic inflammatory disease (PID) or a vaginal or pelvic mass, adds Dr. Belotte.
According to the Centers for Disease Control and Prevention (CDC), bacterial vaginosis (BV) is the most common vaginal infection, affecting 21.2 million people each year. Vaginal yeast infections are also very common, affecting 3 in 4 people with vaginas at least once in their lifetime. Since pregnancy hormones can create an imbalance in vaginal yeast, vaginal yeast infections are very common, but thankfully easily treatable.
Because some of these conditions can harm the fetus, however, it is important to rule them out with your doctor if you're experiencing symptoms, including pain or discomfort during pregnancy sex.
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5. You Have an STI
Dr. Belotte says that sexually transmitted infections (STIs) may also cause painful sex during pregnancy. STIs sometimes have other symptoms as well, ranging from genital sores to painful urination. Many STIs can impact the fetus—for example, herpes can cause neurological problems, and gonorrhea is associated with premature birth and stillbirth—so you should see a doctor if you think you may have an STI.
The CDC recommends that pregnant people get tested for STIs as early in the pregnancy as possible. Many STIs can be treated with either antibiotics or antiviral medications, but a bigger concern is that the STI is not passed from the pregnant person to the fetus. To reduce the risk of spreading or exposure to an STI while pregnant, the CDC also recommends the use of latex condoms during intercourse.
Key Takeaways
For some pregnant people, is painful. But it doesn't have to be! There are many potential reasons for uncomfortable or painful sex during pregnancy. Some of these issues, such as having a vaginal infection or STI, could be harmful to your growing baby. Treatment can often quickly solve the problem and let you enjoy sex again. Contact a health care provider if you have any questions or concerns about pain or discomfort during sex.
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