What to Do About Vaginal Pain During Pregnancy
Pregnancy comes with all sorts of not-so-fun symptoms and side effects. Pressure or pain in the vaginal area is just one more unpleasant thing to add to the list. But it makes sense: Your body is stretching in all sorts of ways to accommodate a rapidly expanding baby. The issue, then, becomes gauging whether you’re experiencing typical pain or something abnormal and worrisome. Is it run-of-the mill round ligament pain, or does the pressure signify a serious issue like preterm labor? The bottom line: It can be unnerving trying to figure out what’s happening to your body, but it’s always better to err on the side of caution and talk to your doctor. In the meantime, if you’re dealing with pressure or vaginal pain during pregnancy, read on to learn what might be causing it and what you can do about it.
There are a few reasons you may experience vaginal pain during pregnancy; the root cause depends on you, your body and where you’re at in terms of gestation. Much of what you’re feeling is tied to your ligaments stretching to accommodate baby’s growth. “Female anatomy is built on the pelvic floor, and it consists of a lot of ligaments that are holding up the vagina and uterus, and supporting the bladder and rectum,” explains Fatiha Johnson, CRNP, a certified nurse practitioner in the obstetrics department at the University of Alabama at Birmingham. “It wears over time, and that elasticity will stretch. And the additional stress [of the uterus] contributes to pelvic pain.” The most common causes of vaginal pain during pregnancy include:
- Round ligament pain. Often occurring in the first trimester, round ligament pain can feel like intense pressure or shooting pain running from the side of your belly down to your groin. It’s due to the hormone relaxin, which helps your body prepare for delivery by loosening the muscles and ligaments in your pelvis, according to the Cleveland Clinic. Relaxin can also lead to discomfort in your pelvic joints. “It’s music to our ears when we hear [about this], because we know that baby is growing,” says Michelle Davis, DNP, a certified nurse midwife and assistant professor of practice at the University of Arizona.
- Bacterial vaginosis or a yeast infection. Bacterial vaginosis or a yeast infection can cause a feeling of vaginal pressure during pregnancy or otherwise, for that matter. Both come with irritation, but they’re caused by different microbes and have slightly different symptoms along with discomfort. Even if you’re not experiencing itchiness or seeing a discharge, talk to your doctor, suggests Davis. “In pregnancy, symptoms may be different,” she adds.
- Urinary tract infection. When you feel pressure down there, it can be hard to pinpoint exactly where it’s coming from, but a UTI may be the culprit. “Sometimes the discomfort is expressed very generally; it can be difficult to figure out if the pain is coming from the rectum, vagina or your urinary tract,” says Wendy Hansen, MD, chair of the ob-gyn department at the University of Kentucky College of Medicine.
- Symphysis pubis dysfunction. Pelvic pain during pregnancy is extremely common; it stems from all that straining of the bones, ligaments and muscles that support your pelvis, says Hansen. Jolting pain—or even persistent discomfort you feel when you use stairs, get in and out of the car or kneel—are symptoms of pubic symphysis dysfunction, also known as pelvic girdle pain.
- Fibroids. Fibroids, or noncancerous growths of the uterus, may cause pain during pregnancy. There’s typically no treatment for fibroids, which feed off the hormones elevated during pregnancy, says Johnson.
- Problems with pregnancy. Vaginal pain could potentially signal miscarriage or preterm labor, says Sarah Cross, MD, an adjunct associate professor at the University of Minnesota Medical School. It may not feel very intense, but preterm labor pain is sometimes characterized by discomfort that comes and goes in an ongoing pattern of repetition, says Hansen.
- STD. Sometimes conditions that were present before pregnancy, like ovarian cysts, endometriosis or sexually transmitted diseases, carry over into pregnancy, says Davis. An STD can cause itching, pain or swelling near your vagina.
Discomfort can hit anytime during your pregnancy, but it’s more likely to occur in the late second trimester or early in the third as your uterus and placenta are significantly bigger, and the amount of fluid you’re carrying is higher stretching out all your pelvic floor muscles. “You’re carrying a lot of weight,” said Hansen.
Pressure or pain in the vaginal area during early pregnancy can happen too, especially when relaxin starts flowing from the placenta. That’s when you may feel those stabbing pains—or for some, dull but strong sensations—associated with round ligament pain. And If this isn’t your first pregnancy, you’re more likely to feel this discomfort early on, as your muscles still may be separated—especially if you’ve given birth fairly recently. “If you’ve had babies back-to-back within a year, the relaxin leftover from the first pregnancy is still circulating around your body,” explains Davis. “Then you get pregnant again, and you get double the amount.”
Vaginal pain early on could potentially be a sign of miscarriage, but try not to panic. “Cramping associated with miscarriage can happen in the first trimester, but a lot of people also have cramping that’s not associated with miscarriage,” says Cross.
How you treat vaginal pain during pregnancy depends on what’s causing it. If it’s something acute, like an infection, you’ll need antibiotics. But if it’s an ongoing issue in pregnancy and simply a result of your body stretching, you may need to find some creative solutions to relieve the discomfort. Experts recommend trying:
- A maternity support belt. A maternity belt or pregnancy belly bands can help support the weight of the uterus and give you some relief.
- Warm baths. Warm—but not hot—soaks can offer relief. Davis suggests adding Epsom salts to the water.
- Physical therapy. “It’s a wonderful benefit during pregnancy—and outside of pregnancy—to help maintain those muscles that are utilized during pregnancy,” says Johnson.
- Light exercise. Johnson says that sitting still and being sedentary can actually exacerbate discomfort. “A 15- to 30-minute walk at the end of the day or some sort of movement is always encouraged, and it’s helpful with blood flow,” she adds.
- Chiropractic care. “If you’re feeling that much pressure and everything checks out, my guess would be that the ligaments are unaligned,” says Davis, adding that a chiropractor who specializes in working with pregnant women—someone certified in the Webster technique—may do the trick.
- Stretching and yoga. Again, gently moving can help, as your body is expanding and changing.
- Prenatal massage. A little TLC in the form of a prenatal massage may do the trick to alleviate some aches and pains.
If you’re feeling any sort of unexplained pain in the vaginal area during pregnancy, call your doctor. “People sometimes say, ‘I don’t want to go in, find out I’m okay and then get sent home,’” says Hansen. “But that’s what we want you to do!”
Pain, stiffness and pressure near your vagina or in your lower back can be completely normal symptoms of a healthy pregnancy, but if it’s accompanied by “any loss of fluid, either clear or bleeding like a period, follow up with a provider,” says Johnson. The same goes if you have a fever, a general unwell feeling or nausea and vomiting, adds Cross.
The onset of preterm labor can be hard to detect. Some women feel nothing; for others, the contractions may feel like a tightening at the top of the uterus moving down and pressure at your bottom, notes Cross. “Fluid leaking or spotting can be subtle at first and is often not like in the movies,” she adds.
Vaginal pain during pregnancy is, unfortunately, par for the course. The good news is that, with the help of your doctor, you can root out the cause and finally find some relief.
Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.
Plus, more from The Bump:
Sarah Cross, MD, is an adjunct associate professor at the University of Minnesota Medical School.
Michelle Davis, DNP, CNM, is a nurse practitioner, certified midwife and assistant professor of practice at the University of Arizona.
Wendy Hansen, MD, is chair of the ob-gyn department at the University of Kentucky College of Medicine. She earned her medical degree from Northwestern University in Illinois.
Fatiha Johnson, CRNP, is a certified nurse practitioner in the obstetrics department at the University of Alabama at Birmingham.
Cleveland Clinic, Relaxin, October 2022
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