Sex During Pregnancy: Causes of Discomfort and How to Relieve Pain

Pain during sex in pregnancy can come from hormonal changes, dryness, certain positions, or infection. Talk to your provider, who can advise.

Common causes

• Hormone changes causing dryness or sensitive tissue.
• Pressure on the growing uterus.
• Round ligament strain.
• Infection (yeast, UTI).
• Certain positions.
• Anxiety.
• Cervical sensitivity.

What helps

• Use lubricant.
• Try side lying positions.
• Communicate with your partner.

See your provider

If pain is severe or comes with bleeding, discharge or cramps.

Safe

Sex is typically safe in a healthy pregnancy.

Why pain may occur

Intercourse during pregnancy is usually safe for healthy pregnancies, but pain can occur because of hormonal vaginal dryness, increased pelvic blood flow and sensitivity, pressure from the growing uterus, round ligament pain, infections (yeast infections are more common in pregnancy) or positions that put pressure on the abdomen.

• Deep penetration can hit a sensitive cervix.
• Braxton Hicks contractions may follow orgasm and are usually harmless.
• Sex is not linked to miscarriage in uncomplicated pregnancy, according to ACOG.

What helps and when to call

Use water-based lubricant, try side-lying or hands-and-knees positions, go slowly and communicate. Call the provider for bleeding, fluid leakage, painful contractions, severe pain or unusual discharge. Providers may advise avoiding sex with placenta previa, preterm labor risk, ruptured membranes or cervical insufficiency. Pelvic floor therapy helps persistent pain.

Why pain may occur

Pain with sex in pregnancy may come from hormonal changes, vaginal dryness, pelvic pressure, positions, infections or conditions such as vaginismus. In general sex is safe in normal pregnancy.

What helps and when to call

Try other positions, lubricants and communication. Call a provider for bleeding, fluid leakage, severe pain, cramping or if told to avoid sex because of placenta previa or preterm labor risk.

Physiology and causes

Pregnancy increases blood flow to the pelvis, and hormones can cause vaginal dryness in the first trimester or when breastfeeding. Pain deep inside may come from the cervix being hit in certain positions. Round ligament pain, yeast infections (more common in pregnancy) and bacterial vaginosis can cause discomfort. Dyspareunia affects 20 to 30 percent of pregnant women.

Practical advice and when to call

Use water based lubricant, side lying or spooning positions and communicate. Intercourse is safe in uncomplicated pregnancy. Avoid it if there is placenta previa, ruptured membranes, preterm labor risk or a cervical issue. Call your provider for bleeding after sex, severe pain, leaking fluid or contractions.

Based on data from the American College of Obstetricians and Gynecologists