What to know about groin pain in pregnancy

Causes and their treatments 

Below are some of the most common causes of groin pain during pregnancy, alongside explanations of their associated symptoms and treatments.

Symphysis pubis dysfunction

The pubic symphysis is a joint that sits between the left and right pubic bones. During pregnancy, the ligaments and muscles that support the joint relax and stretch to accommodate the growing uterus and fetus. This relaxing and stretching causes the pubic symphysis to become unstable, resulting in symphysis pubis dysfunction (SPD).

SPD can cause the following symptoms, which tend to worsen during the second and third trimesters of pregnancy:

• clicking in the hips or pelvis
• muscle spasms or shooting pains in the pelvic area
• sharp, shooting pains in the vagina, perineum, or rectum
• electric shock-like sensations in the vagina or groin area
• pain that radiates from one part of the pelvic area to another

Many women refer to SPD as “lightning crotch” because of the strange electrical sensations they feel. The pain ranges from mild to severe and often gets worse with the following activities:

• transitioning from sitting to standing
• climbing stairs
• carrying heavy objects

Treatment

SPD is not a medical issue but a temporary pain of pregnancy. It does not indicate that there is anything wrong with the pregnant woman or the developing fetus.

For most women, the symptoms of SPD go away shortly after giving birth. In the meantime, gentle hip stretches and exercises may help alleviate the symptoms.

Some women also find relief using the following treatments:

• acupuncture
• chiropractic massage
• application of heat or ice to the pubic region

Round ligament pain

Round ligaments are tough, fibrous bands of connective tissue in the pelvis that attach to and support the uterus. The growth of the uterus throughout pregnancy causes these ligaments to stretch. This stretching can trigger the following symptoms:

• pain that radiates from the groin to the hips or upper legs
• dull aches in the groin or on either side of the stomach
• spasm-like muscle pain on one or both sides of the stomach
• sharp, sudden, intensely painful aches that last for just a second

Many women notice that the pain is worse during sudden movements, such as changing positions in bed or going from standing to sitting or vice versa.

Treatment

Round ligament pain does not indicate an issue with the pregnancy, and it usually goes away shortly after a woman gives birth. In the meantime, some strategies that may help alleviate the pain include:

• bending or flexing the hips before doing anything that tends to cause round ligament pain
• supporting the uterus with the hand before standing, sitting, or coughing
• changing position slowly
• applying a heat pad to the painful area

Vaginal infections

The vagina contains a delicate balance of certain yeasts and bacteria. Vaginal yeast infections occur when there is an overgrowth of yeast inside the vagina. In most cases, there is an overgrowth of a yeast called Candida albicans.

Many factors can cause an overgrowth of yeast in the vagina, including pregnancy. The hormone changes that occur during pregnancy can disrupt the normal pH levels of the vagina, causing yeasts to multiply out of control.

Women who develop a vaginal yeast infection may experience the following symptoms:

• itching and burning in the vagina and vulva
• itching and burning of the perineum or anus
• thick, white vaginal discharge that is usually odorless and resembles cottage cheese
• pain when urinating
• pain when having sex

Treatment

Antifungal medications are the usual treatment for vaginal yeast infections. Women who are pregnant or breastfeeding should not take oral antifungal medications. However, it is safe for pregnant women to apply a topical antifungal cream or insert an antifungal suppository into the vagina.

Women who experience the symptoms above during pregnancy should make an appointment with their doctor or midwife. Certain conditions can cause symptoms that mimic those of a vaginal yeast infection. These conditions will require different treatment.

Vaginal dryness

Some women report experiencing vaginal dryness during pregnancy. Vaginal dryness can cause the following symptoms:

• soreness, itchiness, and general discomfort in and around the vagina
• pain or discomfort during sex
• the need to urinate more often than usual
• recurrent urinary tract infections (UTIs)

Treatment

Vaginal moisturizers can help alleviate vaginal dryness. These are topical medications that a woman can apply to the inside of the vagina.

Water-based sexual lubricants should help alleviate vaginal dryness during sexual activity. However, a woman should not use estrogen-based lubricants during pregnancy.

If vaginal dryness does not get better with home treatment, a woman should talk to her doctor or midwife for further advice.

When to see a doctor

Pregnant women should discuss any and all aches and pains with their doctor or midwife.

Groin pain is a common symptom during pregnancy, and it often has a relatively benign and treatable cause. Nonetheless, a woman should see a doctor to rule out more serious underlying medical conditions. A doctor can also provide treatment to help manage the pain and any associated symptoms.

Anyone who experiences any of the following symptoms during pregnancy should see a doctor as soon as possible:

• severe pain
• worsening pain
• other aches and pains, such as pain in the upper abdomen

If the following symptoms occur during pregnancy, it is important to call a doctor immediately or go to the nearest emergency room:

• painful contractions before the 37th week of pregnancy
• bleeding from the vagina
• fever or chills
• chest pain

Summary

Groin pain during pregnancy is common. It is usually the result of normal hormonal and other bodily changes that occur throughout the pregnancy. Nonetheless, a woman should report any aches and pains to her doctor or midwife. It is important to receive the correct diagnosis and any necessary treatment.

Vaginal yeast infections are highly treatable, and a woman can expect to make a full recovery following appropriate treatment. Vaginal dryness should also improve with home treatment. However, if either of these conditions persists, a woman should go back to her doctor for further advice.

For most women with SPD or round ligament pain, groin pain goes away shortly after giving birth. However, about 1 in 10 women with SPD experience ongoing pain that requires continued treatment. If the pain persists, a doctor may order diagnostic tests to rule out other underlying health issues, such as hip problems or hypermobility syndrome.