Painful Second Trimester Sex Could be Caused by This

After getting pregnant, sex with my husband was different. It was hard to find the same sex drive I had before, because I was dealing with extreme tiredness and morning sickness. And when I made it to the second trimester, I experienced something completely new: pain during sex.

My OB-GYN explained that I was dealing with round ligament pain, which I also sometimes felt when rolling over in bed, walking or getting dressed.

Round ligament pain is caused by stretching of the round ligament that occurs as the uterus grows to accommodate a growing baby. It can complicate 10 to 30 percent of pregnancies, according to a February 2019 study published in the International Journal of Women's Health.

"It is localized to the lower abdominal quadrants radiating to the groin; it is a cramp-like pain which is worse on movement and is more common in multiparous [having borne more than one child] women," the study reported.

Round ligament pain is considered a normal part of pregnancy and is most common in the second trimester, according to the American Pregnancy Association.

But just because it's common doesn't mean you have to suffer, especially during sex.

What causes pregnancy pain during sex?

"The uterus is held in the pelvis by ligaments on either of its sides," explained Kecia Gaither, M.D., M.P.H., an OB-GYN double-board-certified in maternal fetal medicine and director of perinatal services at New York City Health + Hospitals/Lincoln. "During pregnancy, these round ligaments stretch to accommodate the growing uterus out of the pelvic cavity. This growing and stretching of the ligaments can cause sharp stabbing internal pain or a dull ache with movements."

Movements, like those during sex, can trigger your round ligaments and cause them to suddenly hurt.

"Sex can be painful, as the movement can exacerbate the pain," Gaither said.

How can I ease round ligament pain?

Don't try to push through the pain, whether it's happening during sex or any other time.

"Stop and rest from whatever activity is being performed," Gaither said.

To ease the pain, she recommends changing positions, taking a warm bath, wearing maternity support garments and using a pain reliever, such as Tylenol.

"Easing pain may include temporarily pausing any activity that is painful, engaging in physical therapy exercises, using mindfulness and breathing techniques to relax the muscles, or adjusting one's body position for specific activities," said Jennifer Litner, sexologist and founder of Embrace Sexual Wellness, a wellness center offering relationship, sex therapy and sexuality education programming in Chicago.

You may need a care team, which could include a gynecologist and urologist, a physical therapist who specializes in pelvic health, and a sex therapist, according to Litner.

"Treatment outcomes tend to be best when all aspects of pain are addressed, [such as] psychological, medical and physiological," she said.

For me, having sex in a warm shower—with careful support from my partner so I don't slip—helps make sex more enjoyable again.

How can couples navigate painful sex during pregnancy?

"Pregnancy and the transition to parenthood is a destabilizing life event, which means there are lots of adjustments that come with it," Litner said. "While every birthing parent's experience is unique, I recommend partners have an open dialogue about what type of pleasure they feel open to, physical or otherwise, and remain open to adapting the ways they connect intimately throughout this period."

She added that pregnancy can negatively impact sexual desire, but this doesn't mean you have to stop intimacy completely.

"For some, this may feel like a shift from what felt typical before pregnancy, but it is often temporary, as different stages of pregnancy and the postpartum period affect people differently," Litner said.

How should partners communicate about painful sex?

Being open with my husband about my round ligament pain helped so much. Now, we navigate this different sex experience together. Litner encourages couples to communicate about any painful, uncomfortable or unenjoyable sex in a relationship.

"Painful sex can be a challenging experience for partners, especially if it disrupts a sexual dynamic that was previously enjoyable in a relationship," Litner said. "It can also be disappointing, and it's important to be able to process those emotions without blaming one another. If your partner is experiencing sexual pain, please know their pain is likely not because of you, and your best option is to be supportive of their healing."

She offered several tips on communication, including asking the partner with round ligament pain questions like, "What's something that might feel pleasurable right now?" Or the partner in pain could say, "Right now, we need to take a break from X activity. What are some other ways you'd be open to connecting?"

Many people who experience sexual pain frequently feel alone in their experiences, according to Litner, but it is nothing to be embarrassed about.

"While sexual pain affects up to 20 percent of women, according to the World Health Organization, it's often absent from conversations and many people feel shame about it," she said. "It's important to know if you do experience sexual pain, you are not alone and there are treatment options available."

Round ligament pain is just one more annoying pregnancy symptom, but it doesn't have to derail your sex life. With open communication, a little creativity and a lot of rest, you can enjoy sex once again.