6 Causes of Painful Sex During Pregnancy

Painful sex during pregnancy is not uncommon. Here are 6 reasons why pregnancy sex can be painful, and how it can be fixed.

Dr. Gelman-Nisanov
By The Promescent Team Medically reviewed by Dr. Gelman-Nisanov Last updated 12/11/2023
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Ever thought, "Why does my vagina hurt after sex while pregnant?"

Some people claim pregnancy sex is better. With heightened hormone levels and more blood flow, that can be true for some.

Unfortunately, pregnancy sex can be completely the opposite for others. In fact, one study found that over 20 percent of pregnant women experienced significantly painful sex during pregnancy.

Quick FAQs

Pregnancy sex can be painful for different reasons such as vaginal dryness, body changes, and anxiety.

Things that can help with painful pregnancy sex include changing positions and managing anxiety.

Doctors may advise avoiding sex in the final weeks of pregnancy. Follow your physicians advice on when you should stop having sex.

Therefore, vaginal pain after sex during pregnancy is a common problem. So, why is it painful? Take a closer look at the potential reasons.

Why Pregnancy Sex May Be Painful

Without question, pregnancy can come along with some physical discomfort. Something that should be enjoyable—sex—can also be uncomfortable while pregnant.

Thankfully, painful pregnancy sex is relatively common. It of course can be a worrying experience if you've rarely dealt with painful sex before. 

While it is always worth mentioning issues to the OB/GYN, usually, a bit of discomfort during or after intercourse is not something that should cause any major concern.

Women may experience vaginal pain either during sex or vaginal pain after sex during pregnancy. The discomfort may range from dull aching to more sharp and disturbing pains. 

Further, painful sex may only be an issue at certain points during the pregnancy. A number of factors can lead to discomfort during or after sex when you are expecting.

1. Body Changes

Outwardly, it may only look like the breasts and belly are growing. However, pregnancy comes along with other changes to the body that are not so easy to point out.

A few changes that may be taking place inside the body include:

Dr. Faina Gelman-Nisanov, of North Jersey Gynecology, stated that there can be positional discomfort due to change in external and internal body contour. She noted that the third trimester is when intercouse may be more difficult and painful.

Despite these changes causing painful sex, there may be some adjustments that can help. Trying a new sexual position beyond missionary may prevent extra pressure on the stomach. 

Likewise, if uterine enlargement makes sex uncomfortable, it can be helpful for the female to have more control over the depth of penetration.

One other change in the body that Dr. Gelman-Nisanov also mentions that can be a cause of painful sex are contractions of the uterus.

2. Vaginal Dryness

Vaginal dryness is known to cause pain and irritation during intercourse. An increase in progesterone levels during pregnancy can potentially cause women to experience vaginal dryness.

Other factors that might be causing the issue include:

    • Medications like antidepressants, cold medicine, or allergy medicine

      In these cases, using a pregnancy-safe lubricant can be a good option to make sex more enjoyable.

      3. Anxiety

      Fear and anxiety during pregnancy are natural reactions. In a study of pregnant women, over half reported they did not engage in sexual activities during pregnancy due to some level of fear.

      Fear and anxiety associated with sex during pregnancy are more common during the last four weeks of gestation. The most common fears include worry about:

      • Preterm labor or miscarriage
      • Bleeding
      • Risk of infection
      • Injury to the fetus
      • Prematurely rupturing membranes (water breaking too early)

      As a result of the anxiety, it might cause dryness in the vaginal, which makes intercourse more painful.

      One study also found a correlation between body image and sexual function. Women with a poor body image during pregnancy were more likely to have poor sexual function. 

      Overall, anxiety can lead to issues with low arousal and lack of lubrication, which can result in pain during sex.

      4. Sensitive Pleasure Zones

      In some cases, heightened sensitivity during pregnancy can cause sex to be painful.

      Dr. Gelman-Nisanov notes that due to heightened hormone levels causing swelling, there can be physical discomfort at the vagina.

      Even the nipples and other erogenous zones can be more sensitive during sex. While some individuals can find this heightened sensitivity to make sex and touch more enjoyable, for others, the heightened sensations can be uncomfortable.

      If vaginal pain is experienced during or after sex during pregnancy, and it's related to higher sensitivity, it may be a good idea to avoid or reduce direct stimulation to these areas.

      5. Increased Blood Flow

      Red blood count (RBC) volume goes up as much as 30 percent and plasma volume goes up by around half during pregnancy.

      This means the vagina, clitoris, labia, and other areas can be more engorged with blood, appear swollen, and even take on a different hue. This enhanced blood flow can make arousal easier, but it can also change how sex feels for some women.

      For example, vulvar varicosities (vaginal varicose veins) are possible during pregnancy. This occurs when the veins in the vagina are engorged with blood that does not circulate as quickly as normal.

      Unfortunately, either of these can lead to feelings of fullness, pressure, and even pain during or after sex.

      6. Infections

      Infections are a bit more common during pregnancy, whether it is an infection of the genital or pelvic region.

      Infections that can be more common during pregnancy include:

      • Bacterial vaginosis
      • Urinary tract infections
      • Uterine infections
      • Vaginal yeast infections

      All of these infections can change how sex feels. For example, a yeast infection can make the vagina feel itchy and generate burning sensations in the genital area.

      If there's any suspicion that an infection might be causing painful sex, be sure to talk to a doctor. While most infections are easy to treat, a non-treated infection may put the pregnant woman and the pregnancy at risk.

      Takeaways to Remember

      Pregnant women can often wonder why their vagina hurts during sex. There can be many reasons behind the pain. 

      Most root causes are related to the normal changes in the body during pregnancy. However, a few issues should be discussed with the OB/GYN just to keep risks to the mother and the baby low.

      In most cases, a few adjustments can make sex during pregnancy more enjoyable. According to Dr. Gelman-Nisanov, the three main ways to prevent painful pregnancy sex are staying hydrated, avoiding sex when experiencing contractions or abdominal pain, and choosing positions that are comfortable for the body.

      She also stresses that pregnant women should talk to a doctor if they experience any bleeding or pain during intercourse. Being evaluated by an OBGYN will ensure that all is well with the patient and their pregnancy.

      Dr. Gelman-Nisanov

      Dr. Gelman-Nisanov

      Dr. Faina Gelman-Nisanov is a board certified OBGYN with licenses to practice medicine in NY and NJ. She attained her medical degree from Stony Brook University’s School of Medicine. She completed her residency in Obstetrics and Gynecology at Albert Einstein College of Medicine/Montefiore Medical Center in the Bronx, where she was trained in obstetrics and gynecological surgery including laparotomy, hysteroscopy, laparoscopy and vaginal surgery.


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      The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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