Here’s why you might be having painful sex in pregnancy

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Your body changes drastically during pregnancy and everyday things can feel different, including sex. While there are obvious reasons for this (hello, growing baby bump!), other factors can also play a role and as a result, it’s common to experience pain during pregnancy sex. 

In fact, a study published in 2019 found that 1 in 5 women experienced significant pain during sex while pregnant. 

“Dyspareunia (pain during vaginal intercourse) is common in pregnancy and it can happen during any trimester,” says Kin Fertility GP, Dr Kirsty Wallace-Hor. “Unfortunately, it’s not

something that often comes up in conversation with friends, or your doctor or midwife. However, it should be talked about because of the potential impact on relationships and physical and mental health.”

While it’s common, what actually causes painful sex in pregnancy? Dr Wallace-Hor is here to help answer this question and explore how to help make things less painful and more pleasurable in the bedroom. 

The benefits of sex during pregnancy

We wanted to start off by highlighting that sex during pregnancy is totally safe — unless your doctor has told you otherwise. Penetration, anal sex and oral sex can all be engaged with and enjoyed while pregnant.

We’re all aware that orgasms feel pretty damn great but they also have real benefits, including improvements in sleep and stress, which you can reap while pregnant. 

Plus, there are pregnancy-specific positives too, with a British study finding that having sex during the first trimester, in particular, was one of the most important indicators of well-being. So, if you feel like having sex, do it!

Causes of painful sex in pregnancy 

Painful sex is never a fun time, especially when you’re pregnant and may already be feeling a little uncomfortable. With this in mind, we’re exploring why this pain may be happening. 

Physical changes 

The many changes your body goes through during pregnancy can have an impact on your sex life and, according to Dr Wallace-Hor, this is normal. 

“The effect of the physical and hormonal changes we go through during pregnancy can vary but

common things that contribute to discomfort during sex include pelvic and back pain, vaginal

dryness, and increased blood flow to the genitals (which can lead to increased sensitivity and

swelling),” says Dr Wallace-Hor. 

Vaginal bleeding

One thing to keep an eye out for is bleeding during sex as your risk of this increases in pregnancy due to changes in your hormones. Pain coupled with bleeding can cause worry but in most cases, it isn’t anything serious.

According to Dr Wallace-Hor, this bleeding is “due to to cervical ectropion, which is when the cells on the surface of the cervix become more sensitive to trauma with the hormonal changes in pregnancy”. 

“This can often be met with alarm; however, it is not dangerous,” she says. “Of course, if the pain is severe or if you get significant bleeding or changes in discharge, please see your doctor. Whilst some discomfort and bleeding during sex when pregnant can be normal, it can also be due to infections or pregnancy complications.”

Anxiety 

Another factor is anxiety — worrying about pain or the potential risk to your baby can also contribute to the pain you experience during sex. 

“Let me just confirm that it is very safe to have sex during pregnancy unless your doctor specifically advises you against it,” says Dr Wallace-Hor. “The amniotic sac does a great job of keeping your baby safe, and sex will not induce labour in an uncomplicated pregnancy.

“Whilst there are pregnancy complications that can make sex risky, such as placenta praevia (when the placenta covers the cervix), ruptured membranes (when your waters have already broken), or if you’re at risk of premature labour, sex is safe in uncomplicated pregnancies. The main thing to avoid would be positions that put excess pressure on the abdomen.”

How to reduce painful pregnancy sex

Thankfully, there are ways to mitigate painful intercourse when pregnant and the options are easy to action and can make a big difference to your experience.  

Use lubricant 

We know that pregnancy-induced vaginal dryness can make sex painful and nobody has time to be dealing with that. To help reduce friction and dryness, invest in a good quality lubricant that will help keep things slippery during sex. 

Change up your positions

As your pregnancy progresses, you’ll need to mix up your sex positions as this could be causing some discomfort. You’ll want to avoid any positions that put pressure on your belly or that require you to lie on your back. 

Try switching it up with side-lying positions or where you’re on top — this will help to reduce any potential pain and allow you to focus on all of the nice feelings.  

Listen to your body

The most important thing you can do while pregnant is listen to your body and go with how you’re feeling at the time. If you’re experiencing pain during sex, don’t push through it. Change your position, take a break or try some lube. 

Dr Wallace-Hor’s recommendations for easing painful pregnancy sex include “getting on top of things like pelvic and back pain (belly bands and physiotherapists are great for this), liberal use of pregnancy-safe lubricant and trying different positions that are more comfortable. 

“You will usually find different positions are better at different stages of the pregnancy,” she says. “If you have vulval varicosities (varicose veins on the vulva), which can cause pain after sex, wearing supportive underwear and cool baths can help. And if anxiety is a factor, let your doctor or midwife know.”

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