If you experience pain that feels like contractions during or after orgasm during pregnancy, you shouldn’t ignore it. These cramps could be a sign of ectopic pregnancy or placental abruption.
However, you should keep in mind that most pelvic pain after sex during pregnancy is normal and safe, as long as you check in with your doctor.
Increased Blood Flow
Pregnancy causes an increase in blood flow to the pelvic area to support the uterus, fetus and placenta. This can lead to enlarged veins that may cause pain, particularly when you have sex. These can also make you feel like you need to urinate more often, which can cause further discomfort during sexual intercourse.
Another reason you might feel pelvic pain after sex is due to hormonal changes. Hormones can cause tender nipples, an enlarged uterus and dry vagina, which can contribute to discomfort during sex. Some women also have a sensitivity to the prostaglandins found in semen, which can cause painful sex.
Cramping after sex is normal throughout most of the pregnancy, as your uterus grows and gets heavier. However, cramping and contractions that are very painful, come on quickly, or are accompanied by bleeding may be signs of a problem such as early labor, miscarriage or an ectopic pregnancy. It’s important to talk with your practitioner about this.
Your doctor can help you determine what’s causing your pelvic pain and what steps to take for relief. They may prescribe medication to treat the underlying condition causing the pain or recommend different positions for sex that take the pressure off of your pelvic muscles. They can also check your urine for signs of a urinary tract infection, which can also contribute to pelvic pain.
Extra Weight
The uterus and vulva gain weight during pregnancy, which can lead to pressure on the pelvis. In the later stages of pregnancy, this can feel like a dull ache that runs throughout the lower body, Shepherd says. Hormones can also cause veins in the pelvis and vulva to enlarge, which can add to the feeling of pressure during sex.
Pelvic pain can also be caused by stretching and widening of the pelvic ligaments as baby grows. This can happen in the third trimester, and it is a normal part of the pregnancy process. The ligaments that support the uterus, called round ligaments, can stretch and feel uncomfortable during sex because they are attached to the front of the uterus, Shepherd says.
Other common causes of painful sex during pregnancy include a full bladder and a growing cyst. A cyst called a corpus luteum cyst can take time to disappear and may be painful during sex. A full bladder can also put pressure on the pelvis, which can feel uncomfortable during sex. A lubricant can help ease the pain, Minkin says.
Anxiety
Hormonal changes during pregnancy can cause a wide array of symptoms, including tender nipples and breasts, a dry vagina, a low libido and pain after sex. Often, these symptoms are just temporary and nothing to worry about but sometimes it can be hard to know what is normal and what might indicate that something else is wrong.
In some cases, pelvic pain can actually be a sign of an infection that needs to be treated so that it doesn’t spread and put the baby at risk. This can include a yeast infection, urinary tract infection and even pelvic inflammatory disease (PID). These infections may be aggravated during sexual activity as the muscles and ligaments around the uterus become tense.
Other times, the pain is caused by the round ligaments, a pair of cord-like structures that connect the front of the uterus to the groin area. These ligaments can feel strained and painful during and after sex as they stretch in preparation for childbirth, says Shepherd.
Sometimes, the pain after sex is caused by a change in the position or lubrication used during sexual intercourse. It can be helpful for partners to communicate about finding positions that are more comfortable for both parties and to use a safe lubricant designed for pregnancy. It is also important for partners to remember that although sex might feel uncomfortable during pregnancy, it is still possible to be intimate in other ways like kissing and cuddling.
Stress
In addition to hormonal changes that affect vaginal fluids, pregnancy can also cause a condition known as dyspareunia, or pain on the vulva during sexual intercourse. This can be caused by a number of factors including lack of lubrication, overly sensitive nerves and inflammation. It is more common in women and it can be more painful during the second trimester.
The uterus can also get quite big as pregnancy continues, which can make it more difficult for some women to have sex comfortably. If you’re having problems with penetration, try changing your position and using a different type of lubricant.
A hormone called prolactin can increase vaginal secretions and cause dryness, which can also lead to pain with penetrative sex. If this is a problem for you, talk to your doctor about ways to help alleviate the issue.
Occasionally, cramping after sex or orgasm could be a sign of something more serious such as an ectopic pregnancy (where the fertilized egg implants outside the uterus) or placental abruption (when the placenta separates from the uterus). If the pain is accompanied by bleeding or flu-like symptoms, give your doctor a call right away.