Pregnancy + Painful Sex
Experiencing painful sex during pregnancy is an all-too-common experience. Anywhere from 10-69% of pregnant people experience pain during vaginal intercourse, depending on the trimester. But why does it happen and what can you do about it? We talked to Dr. Sasha Davenport, OB/GYN with Atrium Health Women’s Care and Dr. Rachel Gelman, pelvic floor physical therapist, to find out.
Are People Even Having Sex During Pregnancy?
They sure are! But it really depends on the person (and the trimester). Dr. Davenport says the desire to have penetrative sex varies from patient to patient. She explains, “depending on what the pregnant person is experiencing in terms of physical discomfort, emotional state, social situation, etc.—this can certainly impact desire. Often, the nausea that pregnant people experience in the first trimester will decrease the desire to participate in sexual activity. However, I also have patients who tell me their libido has shot through the roof.”
Dr. Gelman adds, “usually around the third trimester [pregnant people] stop or are having sex less. Usually people report that it is just hard to move around in general, so having sex is challenging.”
If you don’t want to have penetrative sex during pregnancy (or really anytime)—power to ya! Here’re some tips for getting it on without getting it…in.
Should I Be Having Sex During Pregnancy?
In a word: only if you want to! Having sex while pregnant includes all the same benefits as having sex outside of pregnancy—bonding, release of feel-good hormones, potentially helping with sleep, and decreasing stress levels.
There aren’t really negative consequences associated with having sex while pregnant unless “a person has a higher risk pregnancy or another situation where their provider has told them not to have penetrative sex,” Dr. Gelman says. Dr. Davenport agrees, saying, “as long as you feel good about having sex, and you and your provider have had a good conversation about any conditions that may preclude it from being safe, it is generally a good thing to enjoy another way of bonding.”
When Should I Not Be Having Sex During Pregnancy?
While having penetrative sex during pregnancy is usually totally safe, there are some medical conditions that might have your doctor telling you to refrain for a bit.
Dr. Davenport says, “This is always an individualized conversation that should occur between a patient and their OB/GYN, as every pregnancy (and individual) is unique and may have certain conditions in which avoiding sexual activity is recommended. Some common conditions in which we would not recommend sexual activity are if your placenta covers your cervix, if you have been told you are leaking amniotic fluid, if you have had unexplained bleeding during pregnancy, or any other condition where your provider has recommended pelvic rest or no sexual activity.”
Barring a medical condition, engaging in penetrative sex during pregnancy is generally safe and won’t hurt the baby, end the pregnancy, or cause premature labor.
Why Does Sex Hurt During Pregnancy?
There are a number of reasons why sex hurts during pregnancy—including reasons why it can be painful in people who aren’t pregnant (like pelvic floor muscle dysfunction). Pregnancy also introduces unique changes in the body that can cause penetration to be painful—like “more pressure on your back and pelvis, which may mean that certain positions or movements are very painful,” says Dr. Davenport.
Beginning in early pregnancy, the body starts making a lot of this hormone called relaxin. Aptly named, it relaxes the ligaments supporting the uterus and softens the abdominal and pelvic floor muscles so the uterus can grow (as well as a bunch of other important functions). This relaxation means that joints can “become lax and that can lead to instability which can then lead to pain that can be aggravated by penetrative sex—or just certain positions may be uncomfortable,” Dr. Gelman explains.
Dr. Davenport says pregnant people may also experience pelvic bone separation, or pubic symphysis dysfunction, which can make penetrative sex (and even activities like walking) uncomfortable.
How Do You Treat Painful Sex During Pregnancy?
Both OB/GYNs and pelvic PTs can be really helpful sources of information and have tools that can be useful for alleviating pain. Dr. Davenport says, “A comprehensive physical exam and history done by an experienced professional is always important in these cases. The causes of pelvic pain, even in pregnancy, can be multifold and it is really important to first determine what is causing the pain before figuring out how to treat it.”
If you need help describing your pain symptoms or need help finding a trusted professional, try out the Pelvic Pain Assessment.
Dr. Davenport also suggests devices that provide pelvic and back support, and says “physical therapy can really help some patients with pain they experience during pregnancy.”
At the PT’s office, Dr. Gelman says, “Assuming they are cleared by their OB for internal examination and treatment, we would first assess the pelvic floor to determine if it is contributing to their symptoms. Then treatment might include techniques to facilitate relaxation of these muscles. We’d also assess and treat the muscles externally. This may involve manual therapy techniques to release any areas that seem tense and doing exercises to help stabilize the joints of the pelvic and improve overall core stability.”
PTs are also great resources for helping you prepare for birth and the postpartum period.
Is There Anything I Can Do On My Own to Treat Painful Sex During Pregnancy?
Other than seeking out your OB/GYN or a pelvic floor physical therapist, Dr. Davenport says, “Communicating with your partner and listening to your body is the first thing I recommend. If something doesn’t feel right or is painful, then listen to what your body is telling you. For some people, certain positions may be more comfortable than others. Depending on where the location of the pain is and what type of pain it is, your physician may recommend specific things. Every individual and pregnancy is so unique, it’s difficult to pinpoint a blueprint that fits everyone.”
There are also tools on the market that may be useful for alleviating pain, depending on your particular situation. If physical therapy is inaccessible to you, Pelvic Gym’s 3rd Trimester Program could be helpful. And if you’re experiencing pain with deep penetration, Ohnut might also be helpful!
Painful sex, whether it’s during pregnancy or any other time in your life, happens more often than we’d like it to—but there are trained professionals and treatment options that can help. So keep talking to your partner(s) and healthcare providers, and know you’re not alone :)