Why Is Sex Painful During Pregnancy? Pelvic Congestion Syndrome Explained
If you’re pregnant and experiencing pain that makes sex impossible, there are relief options available. Find out if pelvic congestion syndrome could be the cause.
By Luis Mejia Sierra, MD, Vascular Surgeon, Vascular Surgery
Painful sex during pregnancy can be caused by pelvic congestion syndrome, a condition where varicose veins enlarge in the pelvic region due to pressure from your growing baby. If your sex life is temporarily paused because it’s too painful, there might be some relief.
What causes pelvic congestion syndrome?
A growing baby puts pressure on the major blood vessels in the abdomen, worsening varicose veins in both the legs and the vagina. Not everyone experiences them, and in many cases, enlarged veins return to normal after delivery. But if you’re one of the many women prone to painful varicose veins, the damage can worsen if you get pregnant again.
In both pelvic congestion and varicose veins, the valves in the veins that help blood flow toward the heart are either faulty or damaged. The valves prevent blood from flowing backward. When the valves are damaged, blood pools in the veins, causing them to enlarge and stretch the vein walls. In pelvic congestion syndrome, the enlarged veins occur near the uterus, fallopian tubes, vulva, and vagina.
Treatment during pregnancy
During pregnancy, treatment options are limited because of radiation risks to your baby, but recommendations may include:
- Wearing surgical compression stockings specifically designed for pregnancy can help improve circulation. Compression of the legs and abdomen helps prevent blood from pooling in the veins. If you already have varicose veins, compression stockings may help prevent them from worsening.
- Staying off your feet for long periods or elevating your legs as much as possible, day or night, to relieve pain.
- Walking, climbing stairs, cycling, and swimming help keep your calf muscles active, which reduces pressure and prevents pooling..
- Flexing your ankles periodically to help pump the blood out of your legs. During extended periods of sitting or standing, flex your ankles 4 or 5 times and repeat every 30 minutes.
- Avoid exposing your legs to excessive heat from sources like hot tubs and hot baths, as heat can enlarge veins and cause blood to pool.
Treatment after delivery
After delivery, several options are available for treating varicose veins, regardless of their location. Your pregnancy care provider will refer you to a vascular surgeon for evaluation and treatment.
For varicose veins in the pelvic region
An MRI can determine if vaginal veins are swollen. If confirmed, a catheter is used to insert coils into the veins to prevent blood from pooling in those areas. The procedure eventually reduces the size of the veins, and they rarely reopen.
Many women wonder if they should wait until they’ve finished having children to schedule this procedure. However, if you’ve been diagnosed with pelvic congestion, there’s no need to wait. Once treated, varicose veins seldom return.
For varicose veins in your legs
An ultrasound can detect leaky valves in the veins of your legs. Treatment options include:
- Intravenous laser therapy: This procedure uses a laser to close the veins, which then shrink over time.
- Microphlebectomy: The minimally invasive procedure removes smaller veins through tiny incisions.
- Sclerotherapy injections: These injections use a special solution to eliminate surface veins, such as spider veins.
Annoying and often painful varicose veins shouldn’t interfere with your life—especially not your sex life. Don't hesitate to discuss your options with your doctor.
Find a Virtua vascular specialist for pelvic congestion syndrome treatment
Our specialists use the latest treatments for vein and vascular problems, including pelvic congestion syndrome. Request an appointment with a Virtua vein and vascular specialist.
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