Vaginal Pain During Pregnancy: 9 Causes (& How to Relieve)

Vaginal pain during pregnancy is a common symptom that can occur as the uterus grows and the baby places increasing pressure on the pelvis. This can affect the pelvic floor, ligaments, muscles, and surrounding nerves, leading to pressure, aching, cramping, or occasional sharp pain.

Vaginal discomfort during pregnancy can also be related to vaginal dryness, sexual activity, or irritation from products such as soaps, condoms, or lubricants. In these cases, symptoms may improve by avoiding irritating products, using adequate lubrication, or making changes to sexual activity as needed.

However, vaginal pain accompanied by burning, unusual discharge, bleeding, fever, painful urination, or severe or persistent cramping may be associated with conditions that require medical evaluation, such as a urinary tract infection, sexually transmitted infection, vulvovaginal condition, or Bartholin gland cyst. Treatment depends on the underlying cause and may include medication, pelvic floor therapy, local measures to relieve discomfort, or changes in daily habits.

What causes vaginal pain during pregnancy?

Vaginal pain or cramping during pregnancy can occur for several reasons. Some causes are related to the normal physical changes of pregnancy, while others may require medical evaluation and treatment.

1. Normal changes during pregnancy

As the baby grows and gains weight, the uterus places increasing pressure on the pelvic floor, surrounding muscles, ligaments, blood vessels, and nerves. This can cause pressure, aching, heaviness, or pain in the vaginal and pelvic area, especially during the third trimester.

According to the American College of Obstetricians and Gynecologists (ACOG), pregnancy can increase pressure on the veins in the pelvic area, which may contribute to swelling and discomfort in the vulvar or vaginal region.

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How to relieve: Resting after activity, avoiding standing for long periods, changing positions regularly, and applying a cold compress to the external pelvic or vulvar area may help relieve discomfort.

However, it is important to see your obstetrician if the pain is severe, persistent, or interferes with walking or normal daily activities.

2. Vaginal dryness

Hormonal changes during pregnancy can affect vaginal lubrication and may cause dryness or discomfort, particularly during sexual intercourse. Stress or anxiety may also contribute to reduced arousal and lubrication.

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How to relieve: Using a water-based lubricant during sexual activity may help reduce friction and discomfort. If dryness is persistent or causes significant pain, consult your obstetrician to determine whether another condition may be contributing to the symptoms.

3. Sexual activity

Vaginal pain may occur after sexual intercourse, especially when there is prolonged or vigorous penetration or insufficient lubrication. Friction can irritate the vaginal tissues and lead to temporary soreness, swelling, or discomfort.

How to relieve: Allowing the area to recover, using adequate lubrication, and choosing positions that cause less pressure or discomfort may help.

If pain occurs frequently during or after sex, or if it is accompanied by bleeding, unusual discharge, or other symptoms, consult your obstetrician.

4. Vaginismus

Vaginismus is characterized by involuntary tightening of the muscles around the vagina, which can make penetration painful or difficult. It may already be present before pregnancy or become more noticeable during pregnancy.

How to relieve: Treatment may involve evaluation by a gynecologist or pelvic floor physical therapist. Depending on the cause, treatment may include pelvic floor therapy, relaxation techniques, counseling, or other individualized approaches.

5. Irritation or allergic reaction

Products that come into contact with the genital area, such as scented soaps, vaginal products, condoms, or lubricants, can sometimes cause irritation or an allergic reaction. Symptoms may include redness, itching, swelling, burning, or pain.

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How to relieve: Stop using any product that appears to trigger the symptoms. A cold compress applied to the external genital area may help relieve mild irritation.

If symptoms do not improve, become more severe, or are associated with significant swelling or discharge, seek medical evaluation.

6. Urinary tract infection

Urinary tract infections, or UTIs, are common during pregnancy and may cause pelvic discomfort or pain, burning when urinating, urinary urgency or frequency, or cloudy or strong-smelling urine.

According to the Centers for Disease Control and Prevention (CDC), pregnancy-related changes can increase the risk of urinary tract infections. If the infection spreads to the kidneys, symptoms may also include fever, chills, nausea, or pain in the back or side.

How to relieve: A UTI during pregnancy should be evaluated by a healthcare professional because treatment with an appropriate antibiotic is often necessary.

Drinking water regularly and urinating when you feel the urge can help support urinary health, but these measures do not replace medical treatment. Learn more about how UTIs are treated during pregnancy.

7. Sexually transmitted infections

Sexually transmitted infections, or STIs, can sometimes cause vaginal or pelvic pain during pregnancy. Depending on the infection, other symptoms may include unusual vaginal discharge, burning, itching, sores, pain during urination, or bleeding.

Learn more about the most common STIs and their symptoms.

How to relieve: If you have symptoms that may indicate an STI, consult your obstetrician or another healthcare professional for testing and treatment.

If an STI is confirmed, treatment will depend on the specific infection. Sexual partners may also need testing and treatment to reduce the risk of reinfection.

8. Bartholin gland cyst

A Bartholin gland cyst can develop when one of the glands located near the vaginal opening becomes blocked. Small cysts may not cause symptoms, but larger cysts can cause a lump, swelling, pressure, or pain, especially when walking, sitting, or having sex.

If the cyst becomes infected, it can develop into an abscess and cause more intense pain, redness, swelling, or fever.

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How to relieve: Small, uncomplicated cysts may improve with warm sitz baths several times a day. Avoid squeezing or attempting to drain the cyst yourself.

If the cyst is very painful, becomes larger, or shows signs of infection, consult your doctor, as drainage or other treatment may be necessary.

9. Lightning crotch

“Lightning crotch” is a commonly used term for sudden, sharp, shooting, or electric-like pain felt in the vagina, cervix, or deep in the pelvis during pregnancy.

It is more common during the third trimester and is thought to be related to pressure or irritation of pelvic nerves and structures as the baby grows, changes position, or moves lower into the pelvis.

How to relieve: Changing positions, moving more slowly, resting, or gentle stretching may help reduce discomfort. Some women may also find a pregnancy support belt helpful when pelvic pressure is contributing to symptoms.

Although lightning crotch is usually brief, medical evaluation is recommended if the pain becomes severe or persistent or occurs with vaginal bleeding, leaking fluid, regular contractions, or other concerning symptoms.

Sharp vaginal pain during pregnancy

Sharp vaginal pain during pregnancy may feel like a sudden stabbing, shooting, or electric-like sensation in the vagina or deep in the pelvis.

Later in pregnancy, this type of pain is often related to increased pressure on the pelvic floor, surrounding nerves, and other pelvic structures as the baby grows and moves lower into the pelvis.

Some women experience brief, intense episodes of pain commonly described as “lightning crotch.” Although this is not a formal medical diagnosis, it is generally used to describe sudden, short-lived vaginal or pelvic pain caused by pressure or irritation in the pelvic area.

Sharp vaginal pain is not always harmless, however. Depending on the stage of pregnancy and any associated symptoms, it may be related to a condition that requires medical evaluation.

Medical care should be sought promptly if the pain is severe, persistent, or worsening, or if it occurs with vaginal bleeding, leaking fluid, regular contractions, fever, painful urination, dizziness, fainting, or severe abdominal or pelvic pain. These symptoms may indicate a complication that requires prompt assessment.

Is vaginal pain normal during pregnancy?

Vaginal pain can be normal during pregnancy when it is mild, brief, and related to the physical changes that occur as the uterus grows and pressure on the pelvis increases.

Some women may experience pelvic pressure, aching, or occasional sharp or shooting sensations in the vaginal area, especially during the second and third trimesters. Pregnancy-related pelvic girdle pain and increased pressure on the pelvic floor can also contribute to discomfort.

However, vaginal pain can sometimes be related to a condition that requires medical attention. The possible cause depends on the stage of pregnancy, the type and intensity of the pain, how long it lasts, and whether other symptoms are present.

What can cause vaginal pain during pregnancy by trimester?

The causes of vaginal pain can vary throughout pregnancy. In early pregnancy, pain may be more closely related to uterine changes or conditions such as ectopic pregnancy, while later in pregnancy it is more often associated with increasing pressure on the pelvis, musculoskeletal changes, or labor.

1. First trimester

During the first trimester, vaginal or pelvic pain may be related to:

• Normal uterine changes: as the uterus begins to grow, some women may experience mild cramping, pressure, or pelvic discomfort.
• Pelvic floor or musculoskeletal pain: changes in posture, ligaments, and pelvic structures can begin early in pregnancy, particularly in women with a history of pelvic or lower back pain.
• Urinary tract infection: a UTI can cause pelvic discomfort along with burning when urinating, urinary urgency, or frequent urination.
• Vulvodynia or other vulvar pain conditions: women with preexisting vulvar pain may continue to experience symptoms during pregnancy. The pain may improve, remain unchanged, or worsen.
• Ectopic pregnancy: pain in early pregnancy, especially if it is severe, one-sided, or accompanied by vaginal bleeding, dizziness, shoulder pain, weakness, or fainting, requires urgent medical evaluation.

Mild cramping or pelvic discomfort can occur as the body adapts to pregnancy. However, intense or one-sided pain, particularly when accompanied by bleeding or other concerning symptoms, should be evaluated promptly.

2. Second trimester

During the second trimester, vaginal pain is often more closely related to changes in the pelvis and the increasing size and weight of the uterus.

Possible causes include:

• Pelvic girdle pain: pregnancy-related pelvic girdle pain can affect the front or back of the pelvis and may sometimes be felt deep in the pelvic or vaginal area. It may worsen with walking, climbing stairs, turning in bed, or standing on one leg.
• Ligament and musculoskeletal strain: as the uterus grows, the pelvis, abdominal muscles, and surrounding ligaments are placed under greater strain, which can cause pulling, aching, or sharp discomfort.
• Pelvic floor pressure: the growing uterus can place increasing pressure on pelvic structures, causing heaviness, pressure, or pain.
• Urinary tract infection: UTIs remain common during pregnancy and may cause pelvic discomfort, painful urination, urinary frequency, or, in more severe cases, fever and pain in the side or back.
• Preterm labor: before 37 weeks, pelvic or vaginal pressure accompanied by regular contractions, lower back pain, changes in vaginal discharge, bleeding, or leaking fluid should be evaluated promptly.

Most discomfort during the second trimester is related to increasing strain on the pelvis and surrounding structures. However, symptoms that suggest a urinary infection or preterm labor should be assessed by a healthcare professional.

3. Third trimester

Vaginal or pelvic pain becomes more common during the third trimester because of the baby's increasing weight and the greater pressure placed on the pelvis.

Possible causes include:

• Increased pelvic pressure: as the baby grows and moves lower into the pelvis, pressure on the pelvic floor, cervix, and surrounding nerves may cause aching, heaviness, or sudden sharp sensations.
• Pregnancy-related pelvic girdle pain: this may become more noticeable as pregnancy progresses and can make walking, changing positions, or performing other daily activities more difficult.
• Brief, sharp, or electric-like vaginal pain: some women experience sudden stabbing or shooting pain deep in the vagina or pelvis, sometimes described as “lightning crotch.” This is a commonly used term rather than a medical diagnosis and is generally associated with pressure on or irritation of pelvic structures and nerves.
• Cervical changes and approaching labor: pressure in the vagina or pelvis may increase as the cervix begins to change and the baby moves lower into the pelvis.
• Preterm labor: if symptoms occur before 37 weeks, regular contractions, persistent pelvic pressure, lower back pain, vaginal bleeding, changes in discharge, or leaking fluid should be assessed by a healthcare professional.
• Labor at term: near the end of pregnancy, increasing pelvic pressure and pain may occur along with regular contractions or rupture of the amniotic sac.

During the third trimester, pelvic pressure and brief sharp sensations may become more noticeable as the baby grows and moves lower into the pelvis.

Persistent or increasing pain, especially when it occurs with signs of labor, should be evaluated.

Vaginal pain during pregnancy should be evaluated promptly if it is severe, persistent, or worsening, or if it occurs with vaginal bleeding, leaking fluid, regular contractions, fever, painful urination, severe abdominal or pelvic pain, dizziness, weakness, or fainting.

These symptoms may indicate a urinary tract infection, preterm labor, ectopic pregnancy in early pregnancy, or another obstetric or gynecologic complication.