Key takeaways

  • Pain in the uterus in early pregnancy can have a range of possible causes. These include pelvic pain, ligament pain, and cramping. Some causes are common, while others, such as ovarian torsion, occur less frequently.
  • The pain may feel sharp, and it may get progressively worse. A healthcare professional can help determine the cause of uterine pain.
  • After diagnosis, a healthcare professional can advise on treatments to manage pain. Remedies depend on the cause, but may include massage, shifting sitting positions, and pain relief medication.

During early pregnancy, the uterus is much smaller than it will be in the second and third trimesters. Therefore, pain in this part of the body is unlikely to be due to pressure from the uterus pushing on other organs or the fatigue of excess weight in the uterus.

Uterus pain, however, remains one of the most common symptoms in early pregnancy. In this article, learn about the possible causes, which include changes to the muscles and hormones.

The following are some of the most common causes of uterine pain in early pregnancy.

Round ligament pain

Round ligament pain happens because the uterus is growing, and the ligaments that support it must shift to accommodate the growth. This pain is usually a sharp, stabbing sensation that can happen on one or both sides of the uterus. It may be sudden and usually only lasts a few seconds.

Some people notice more pain when they cough or sneeze or when they roll over or change position in bed. The pain can also occur when a pregnant person moves from a sitting to a standing position.

Round ligament pain is more common after the first trimester, but it may also occur early on.

Pelvic pain

Many people experience pelvic pain during pregnancy. It is also known as pregnancy-related pelvic girdle pain (PGP) and symphysis pubis dysfunction (SPD).

Symptoms can include:

  • pain across one or both sides of the lower back
  • pain over the pubic bone
  • perineum pain, between the vagina and anus
  • pain that affects the thighs

The pain may worsen when walking, using stairs, or moving the legs.

Cramping

Early in pregnancy, many people experience cramping that feels similar to menstrual cramps.

Some people worry that cramping is a sign of pregnancy loss. Severe cramping that gets steadily worse may warn of a pregnancy loss, especially if there is bleeding.

For many pregnant people, however, cramping is a temporary discomfort and not a sign of a problem.

The following are less common causes of uterine pain in early pregnancy.

Ovarian torsion

Ovarian torsion happens when an ovary or fallopian tube twists around the tissues supporting it. In some people, this happens following an ovarian cyst. In others, there are no previous symptoms or warning signs.

Although pregnancy does not cause ovarian torsion, it can occur during pregnancy. Ovarian torsion is a medical emergency because it can cut off the blood supply and destroy the ovary.

The ovary may rupture, which can lead to life threatening bleeding. Prompt emergency treatment is important for the survival of both the individual and the developing fetus.

Ovarian torsion causes sudden, sharp, overwhelming pain that may get steadily worse. The pain does not go away or get better with massage. For some people, the pain is intense enough to cause vomiting or fainting.

Ectopic pregnancy

An ectopic pregnancy happens when an egg implants and grows somewhere other than the uterus — usually in the fallopian tubes.

Factors that increase the risk of ectopic pregnancy include:

  • being over the age of 35 years
  • previous pelvic surgery
  • being a smoker
  • a history of ectopic pregnancy or pelvic inflammatory diseases
  • endometriosis
  • sexually transmitted infections (STIs)
  • in vitro fertilization (IVF)

An ectopic pregnancy is not viable. If it continues to grow, it may damage organs or cause life threatening bleeding.

Once a pregnancy implants in the uterus, it will not move to another location. If an ultrasound confirms that the fetus is developing in the uterus, an ectopic pregnancy is unlikely.

The right treatment depends on the cause of the pain.

People who experience early pregnancy aches and pains, such as those that are due to pelvic floor discomfort or round ligament pain, may find relief by:

  • shifting the knees toward the chest to reduce pressure on the uterus
  • frequently changing position
  • massaging the affected area or surrounding muscles gently
  • using over-the-counter pain relievers under the supervision of a healthcare professional
  • getting plenty of rest to reduce muscle fatigue

Surgery can treat ovarian torsion. In some cases, the surgeon will be able to save the ovary, but sometimes it may be necessary to remove the ovary.

A healthcare professional must end an ectopic pregnancy, either surgically or using medication.

A pregnant person should contact a healthcare professional about uterus pain if:

  • there is intense cramping
  • the pain gets worse over time
  • pain occurs alongside blood in the stool
  • there are signs of liver problems, such as upper right abdominal pain

Go to the emergency room if:

  • there is heavy bleeding, similar to a period
  • the pain is unbearable or comes on suddenly and does not go away
  • symptoms include a fever
  • there is blood in the urine
  • there are symptoms of a kidney stone, such as intense back pain and cramping

For most people, uterus pain in early pregnancy is a temporary discomfort that comes and goes. Common causes include round ligament pain, pelvic pain, and cramping.

When pain is intense or occurs alongside other symptoms, it is important to see a healthcare professional. It could be due to a less common but serious condition, such as ovarian torsion or an ectopic pregnancy.