A pregnant woman's uterus will expand from the size of an orange to the size of a watermelon or larger. Her body will not only need to provide space and nutrients for a new person to develop but will have to produce an entirely new organ in the form of a placenta.
With so many changes happening, it is not surprising that many women notice sudden and unusual shifts in how their bodies feel. Vaginal, pelvic, or lower abdomen pressure is common in all three trimesters of pregnancy.
Read on to learn about the causes and symptoms of vaginal pressure during each stage of pregnancy, as well as treatment options and possible complications.
Causes of vaginal and pelvic pressure during pregnancy
Vaginal pressure is a common experience in pregnancy.
Women will have different experiences of vaginal pressure during pregnancy.
Some may feel an intense pressure in the vagina, while others will have a dull ache throughout the pelvis, or feel like a weight is bearing down on their entire lower body.
Late in pregnancy, this pressure is often due to the baby's weight pressing down on the pelvic floor, but many other factors can cause pelvic pressure during pregnancy.
Below, we discuss the different causes of vaginal pressure according to the trimester a woman is in:
For most women, the first trimester is too early in pregnancy for weight gain to cause vaginal pressure.
Instead, the hormone relaxin is often responsible. This hormone helps relax the muscles, making it easier for the baby to pass through the pelvic area during birth. However, relaxin levels are at their highest in early pregnancy. High levels of this hormone may help the fertilized egg to implant in the lining of the uterus.
For some women, relaxin can cause muscle pain or tension, including in or around the vagina.
According to studies in animal models, relaxin may also weaken the ligaments that support the pelvis. This can lead to a feeling of pressure, as though something is pushing down on the vagina.
Second and third trimesters
In the second and third trimesters, the combination of a weakening pelvic floor and increased weight putting pressure on the pelvis can cause vaginal pressure.
The pelvic floor resembles a sling made of muscle. It supports the organs of the pelvis, including the uterus, vagina, urethra, and bladder. Pregnancy can weaken the pelvic floor.
Women who have given birth previously may have damage to their pelvic floor, which could cause it to weaken further with a subsequent pregnancy.
The extra weight of pregnancy often becomes more noticeable in the second trimester. As pregnancy progresses, the uterus puts more and more pressure on the lower body.
As the pelvic floor weakens, this pressure can cause a feeling of fullness in the vagina or generalized pain and pressure in the hips and pelvis.
For some women in the later stages of pregnancy, a pressure in the pelvis may be an early sign of labor. If cramping in the stomach also occurs or they feel a sensation of something pressing down on the uterus, it could mean that they are about to give birth.
Common problems in all trimesters
A number of conditions can cause vaginal pressure.
Some factors can cause a feeling of vaginal or pelvic pressure in all stages of pregnancy. These include:
Many women struggle with constipation throughout their pregnancy. Constipation can cause a feeling of fullness or pressure in the vagina, especially when the stool is hard or several days have passed since a bowel movement.
Drinking plenty of water and eating fruit and other high-fiber foods may help with constipation.
For some women, pressure or pain can signify a bladder infection. Women are more likely to develop a bladder infection during pregnancy.
If the vaginal or pelvic pressure occurs alongside difficulty going to the bathroom, pain when urinating, or fever, it is essential to see a doctor.
Bladder infections are easy to treat, but, without treatment, they can worsen and increase the risk of health issues during pregnancy.
Pelvic organ prolapse (POP)
When vaginal pressure is intense, it could be a sign of POP. POP happens when organs in or near the pelvis move down, sometimes into the vagina or rectum.
POP is treatable but can cause incontinence, intense pain, and severe complications.
Women who suddenly feel intense pressure, have difficulty controlling their bowel or bladder, or notice that something seems to be pushing down into their vagina, should consult a doctor.
A weak cervix
Some women have a weak cervix, which is sometimes called cervical incompetence or cervical insufficiency.
Some women with this condition may have a miscarriage or go into premature labor because the cervix is not strong enough to support the uterus. In most cases, a weak cervix is treatable with early intervention.
Women who feel unexplained vaginal pressure, especially early in pregnancy, could ask a doctor to check their cervix. A previous cervical procedure or injury, including those resulting from childbirth, may increase the risk of a weak cervix.
How to relieve vaginal pain and pressure
As vaginal pressure is often due to weak muscles and pressure on the pelvis, gentle stretches may help. Try stretching the back and hips to relieve pain and pressure.
A pregnancy yoga or gentle stretching class can help with finding comfortable and safe stretches.
Using a foam roller can help loosen tense muscles. If the pain is intense, applying a heating pad to the sore area may help. Keep the heat low, and remove the pad after a maximum of 10 minutes.
Other strategies may not offer immediate relief, but can reduce the risk of certain conditions that cause vaginal pressure. These strategies include:
- Doing Kegel pelvic floor exercises. Tense the pelvic floor muscles as though trying to avoid urinating, hold for 10 seconds, then release. Repeat 10 times at least twice a day. This can also strengthen the muscles that the body uses to push out the baby.
- Remaining active during pregnancy. Even low-intensity exercises such as walking can help strengthen the muscles and promote good posture. This may relieve pain and pressure and keep the pelvic muscles strong.
- Drinking plenty of water. Stay hydrated, especially after exercising and in hot weather. This can help prevent constipation, which could otherwise lead to pressure.
A doctor will prescribe treatment if an infection is causing the vaginal pressure.
In most cases, vaginal pressure is just an unpleasant pregnancy side effect resulting from weakened pelvic muscles and weight gain.
However, sometimes a more severe cause will need treating so that it does not harm the woman and baby. An untreated infection, for example, can spread throughout the body and put the baby in danger. It might even cause premature labor.
Very weak pelvic muscles can lead to POP. This painful condition can cause incontinence, pain during sex, and changes in the appearance of the genitals.
Some women experience muscle injuries during pregnancy or when giving birth. The hormone relaxin may increase the risk of muscle injuries. So it is important to remain physically active to keep the muscles strong. Always lift with the legs rather than the back, and see a doctor for unexplained muscle pain.
Any injury that a woman experiences during pregnancy can make childbirth more difficult. Pregnancy-related complications may also make the postpartum period more difficult, slowing recovery and potentially harming mental health.
When to see a doctor
Women should see their doctors or midwives routinely during pregnancy. It is vital to use these visits to discuss all symptoms, even if they seem minor.
Early in pregnancy, women may only see a doctor every few weeks. If they are experiencing intense pressure or pain or have other symptoms, such as fever, painful urination, bleeding, or a change in the baby's movements, it is important that they seek medical care immediately.
If it is after hours, they should go to the emergency room. Prompt treatment of pregnancy conditions can save both the woman and the baby.
Vaginal pressure during pregnancy is just one of the many symptoms women may experience while pregnant. It should not usually be cause for concern and can be a good sign that the body is releasing the right hormones, and the uterus is growing as expected.
A bit of caution in pregnancy can help to detect problems before they become emergencies. Never hesitate to see a doctor, even if the issue seems minor. It is unlikely that there is a severe problem, but reassurance can make pregnancy easier. If something is wrong, it is best to catch the issue as early on as possible.