Painful Sex During Pregnancy? Let’s talk about it.

Pregnancy causes multiple changes to your body, some of which might make sex uncomfortable. In this post, we’re unpacking the most common reasons why sex might be painful during pregnancy and the things you can do to navigate your pregnancy sex life with more ease.

Having sex while you’re pregnant doesn’t have to be a negative experience. In fact, sex at this time is a good way to promote intimacy and mental wellbeing at a time when a lot of changes are happening in your body.¹

Hormones play a vital role in maintaining a healthy pregnancy but can also cause an array of side effects² such as nausea and vomiting, fatigue, tender breasts, low libido and other changes that might make sex uncomfortable. While these symptoms can be annoying, they are totally normal. Identifying which trimester you’re in is one way to narrow down why you might be experiencing painful sex at this time.

Bada bing bada boom! You’re pregnant.

Here are the top causes of painful sex during the first trimester

The first trimester is weeks 1 to 12 of pregnancy.³ If sex is painful during this time it could be because of:

1. Vaginal dryness

Remember how the changing hormone levels tend to bring on an onslaught of other effects? When oestrogen levels drop, you may also experience vaginal dryness and/or itching.

What can help: Try a hormone free vaginal gel or use a water-based lubricant for sex

2. Uterus growth

The initial stretch as your womb expands to accommodate the growing baby, can mean sex feels a bit more uncomfortable at this time. This often feels like mild cramping.

What can help: Book a chat with our knowledgeable pelvic health physio for advice and tips for coping with this.

3. A full bladder

Pregnancy can make you feel you need to pee more often than you used to. The increased pressure on the bladder can make sex uncomfortable for some people.

What can help: Our pelvic health physio can also provide support on this. Click here to arrange a call.

4. An infection

We’ve touched on this and other common causes of pain during sex while pregnant here. Sexually transmitted infections (STIs) such as chlamydia and gonorrhoea are associated with a higher rate of complications during and after the pregnancy period and can be passed on to baby.⁴ 

What can help: If you haven’t had one recently then get an STI screen early on in your pregnancy, and ask your partner to do the same. This is especially important if you and/or your partner have multiple sexual partners.

Causes of painful sex in the second trimester

In your second trimester (weeks 13 to 27) causes of painful sex might be:

1. A yeast infection (thrush)

This is especially common during the third trimester and can cause vaginal soreness and discomfort.⁵

What can help: Thrush during pregnancy can be treated with a cream or tablet inserted into the vagina (pessary). Always speak to your primary healthcare team or midwife before starting any medications while pregnant.

2. Pelvic congestion

Increased blood flow to the abdomen and pelvis during pregnancy can result in enlarged veins in the pelvis. This tends to feel like pressure in the vagina or a deep ache in the pelvis particularly after sex.

3. Round ligament pain

This happens when the ligaments that support your uterus (womb) start to soften and stretch as the baby grows.⁶ Round ligament pain tends to feel like a sharp pain or cramp to one side of your stomach.⁷ It is super common and not harmful to baby but it can make sex uncomfortable in certain positions.

What can help: regular light exercise, warm baths, avoiding sudden movements.⁸

4. Pelvic Girdle Pain (PGP)

Some women experience this in pregnancy, and it is due to the increased levels of progesterone and relaxin hormones which relaxes the muscles, making them more elastic and mobile. This causes joint instability leading to pain in the pelvic region. If you experience stabbing pain during sex while pregnant, it might be likely due to PGP. You can read more about it here.

What can help: Consider different positions for sex while pregnant, such as lying on your side or kneeling on all fours. Antenatal physiotherapy can also be useful to help with PGP.

Painful sex during the third trimester

Your third trimester begins in week 28 and lasts until childbirth. If you experience pain during sex at this time, it could be because of the following:

1. Swelling of your labia and vagina

As the pregnancy progresses and the baby continues to grow, this puts increasing pressure on the blood vessels in your abdomen and pelvis – that includes your nether regions.

2. The weight of a heavy uterus

This can make sex uncomfortable in certain positions.

What can help: Scroll down for some sex positions to try!

3. Pelvic stretching

In the final stage of pregnancy, your pelvis widens to prepare for labour and this can make penetrative sex feel uncomfortable.

4. Orgasms or sex itself can set off mild contractions known as Braxton Hicks

While these may feel uncomfortable, they are normal and not a cause for alarm.

What can help: Try to relax. Lying down until the contractions pass may also help.⁹

Should I stop having sex if it hurts?

For the majority of people, sex is absolutely fine during pregnancy and only requires some adjustments to make it more comfortable. But there are some instances when it’s a no no. 

If your doctor or midwife has advised that you don’t have sex, please don’t. 

This advice could be for various reasons, such as:

• If you are found to have a low-lying placenta, a condition known as placenta praevia that affects 1 in 200 pregnancies in the U.K.¹⁰ You can read more about placenta praevia here
• If you are at risk of going into early labour or have any problems with your cervix
• If you’ve been told you have a high risk of miscarriages
• If you are experiencing heavy bleeding. It’s important to get this checked out ASAP at any point during your pregnancy
• If your waters have broken, sex can increase your risk of developing an infection but most importantly, if your water breaks early (before 37 weeks) you should seek medical attention ASAP.¹¹

In summary, pregnancy is a special, complex time for multiple reasons but your sex life doesn’t have to suffer unless you are following strict medical advice. If in doubt or something doesn’t feel right, always speak to your healthcare team for clarity. And remember – being open with your partner about your discomfort and your evolving relationship with your body is vital for maintaining your wellbeing.

Best positions for sex while pregnant:

Check out our little list for improving your sex life:

• Lying side by side is one way to comfortably have sex during pregnancy. This can either be facing your partner or with your back to them 
• Cow girl, where the pregnant partner is on top, can be a great way to have sex without your growing bump getting in the way
• Try having sex with your partner penetrating you from behind. This could either be with you both standing up or with you on all fours
• Use pillows to support you where necessary!