Vaginal Pressure During Pregnancy: When to Expect, Causes, Treatment, Warning Signs

With baby growing in the womb, the pregnant woman experience many changes in the body. Many pregnant women experience abdominal and vaginal pressure as the uterus expands, however, sometimes vaginal pressure during pregnancy may be a matter of concern. Let us look at the various causes of vaginal pressure during pregnancy and ways to differentiate vaginal pressure and vaginal pain in pregnancy.

As a baby grows inside a woman, it stretches her body. The amount of fluid present in the uterus increases and starts exerting more pressure to accommodate the growing baby, nourish it well and provide it with all essential nutrients for an ideal growth and development. The blood volume in women also increases to two-fold during pregnancy. Women usually complain of heaviness due to sudden increase in the fluid pressure and blood volume. They experience a downward pull which exaggerates the heaviness and pressure in the uterus and vagina. This is a common phenomenon which leads to vaginal pressure in pregnancy.

Being a complaint in women, it is experienced by some pregnant women throughout gestation. It is not specific for delivery or labor. Women experience extra vaginal pressure during the first and second trimesters of gestation as well however it is almost negligible during the first and second trimesters, the fetus growing in the womb of a woman is very small and cannot cause vaginal pressure in pregnancy.

Vaginal pressure in pregnancy is usually felt when you move or exert yourself and its occurrence and intensity often varies from woman to woman. It may be experienced during climbing of stairs, brisk walking or even strolling in some cases. Vaginal pressure during pregnancy is more common in the last trimester, as the uterus expands and the baby grows in size and weight. It is related to the position of the baby in the uterus and the weight of the baby. Due to center of gravity a baby with a higher than average expected fetal weight will be heavier and can exert more vaginal pressure during pregnancy. Sometimes, the pressure exceeds enough to cause pain due to contractions in the pelvic region of the pregnant woman.

Pain and vaginal pressure during pregnancy are two individual entities. They are felt and treated differently. Sometimes pain is confused with pressure. Pain results when the pelvic pressure is high enough to stimulate contractions of the pelvic muscles. Such a condition can be dangerous for a pregnant woman and must receive immediate medical attention. Pain in the pelvic region is sharp in character, usually associated with dizziness and swelling of the hand and feet. When a pregnant woman experiences pain, it is almost impossible for her to walk or even talk comfortably.

However, vaginal pressure during pregnancy does not cause any such symptoms. It exerts pressure or simply puts a feeling of heaviness in the pelvic or more specifically in the vaginal region which are somewhat similar to menstrual cramps. This is mostly in association with lower back pain.

To be able to manage the condition better, it is important to know the causes of vaginal pressure during pregnancy.

• Weight and Size of the Fetus – During the late second and third trimester, the growing baby and expansion of the uterus to accommodate the baby results in vaginal pressure during pregnancy. As the size of the fetus increases, its weight consequently increases as well. Increased fetal weight exerts pressures on the pelvic muscles supporting the bladder anteriorly and the rectum posteriorly. It also leads to increased pressure on the nerves and blood vessels, which cause smooth muscle contraction and compression of these vessels and nerves, ultimately, results in pain. The amniotic fluid and placenta also exert pressure on the pelvis which is exaggerated due to gravity. As labor approaches, the head of the baby descends within the pelvis towards the cervix. All these factors contribute to vaginal pressure during pregnancy.
• Role of Relaxin Hormone – This hormone is released towards the end of pregnancy, near the time of delivery in the third trimester. It helps in loosening the ligaments that are attached to the pelvic joints and muscles which form the floor of the pelvis, thus helping in making room for the baby and ensuring the pelvis is ready for delivery. This can cause pain in the pelvic bones and cause vaginal pressure during pregnancy. As the fetus moves in the womb, it creates tension by overstretching the ligaments which are already working under the pressure of the hormone relaxin and increase the vaginal pressure during pregnancy.
• Constipation – Increased production of hormones and increased intake of iron during pregnancy can cause reduced bowel movements in most pregnant women. This is another contributing factor in increasing vaginal pressure during pregnancy. However, increased water intake, consumption of fiber and use of laxatives can help in relieving this pressure.
• Increased blood flow – Pregnancy increases the workload on the woman. She needs to meet the nutritional demands of her body as well as those of her growing baby. To meet the increasing requirement and to provide nutrition to the fetus, the average blood volume increases. An abrupt increase in blood flow causes the vagina and labia to swell and become tender, which too increases vaginal pressure during pregnancy.
• Varicose – An increase in blood volume causes an increased pressure on the veins of the legs. This is due to gravity, which pulls blood in veins towards the ground, where in turn it moves upwards i.e. in an opposite direction. A greater amount of blood is to be pushed back to the heart per minute through veins. During pregnancy, progesterone is secreted in a pulsatile manner which causes dilation in the blood vessels allowing the accommodation of extra blood in large vessels. When veins are over dilated they cause pooling of blood called varicose veins. Varicose veins in pregnant women occur more commonly in the veins of the rectum causing hemorrhoids. When varicose veins occur in the uterus, vagina or vulva, it exerts more pressure on the pelvic walls resulting in increased pressure sensation in women and a subsequent increase in vaginal pressure during pregnancy. This may also result in increased pain in pregnant women.

Although normal, vaginal pressure during pregnancy can be troublesome, so here are some warning signs that you need to watch out for.

As vaginal pressure during pregnancy is expected in the last months, any pressure or pain during the first trimester, can be a warning sign. Medical opinion must be taken. It is essential that pelvic pain should be distinguished from pelvic pressure, as pelvic pressure can lead to miscarriage, preterm labor or even placental abruption.

Vaginal pressure is fine, but if there is sharp pain along the pelvic floor, or around the vagina or in the abdomen, it may be a warning sign. Also, sharp pain, which is squeezing in nature, giving the woman a sensation of building up of pressure can increase the risk of early labor. If exaggerated fetal movements are felt in the abdomen or movements have completely stopped immediate medical help is needed. Leaking of waters or vaginal discharges with increased pressure is also a warning sign and must be attended at once.

As the uterus expands during the early phase of pregnancy, it causes mild cramps in pregnant women. If pregnant women experience cramps more than usual and are associated with pressure sensation in the vagina, there is a greater risk of miscarriage. Vaginal bleeding is also a sign of miscarriage, hence needs medical attention.

If the vaginal pressure during pregnancy is not due to any gestational and is only due to normal reasons of vaginal pressure, there are several ways to offer relief.

Here are some of the ways to manage normal vaginal pressure during pregnancy:

• Massage – Massage can bring temporary relief to women by relieving vaginal pressure during pregnancy. Pelvic and abdominal massage can help, but it is important to be careful and do it from a trained therapist after seeking medical opinion.
• Rest – Rest can help in relieving vaginal pressure during pregnancy. It is advisable to perform work in sitting position, if comfortable or lying down can surely help. When lying down on the bed, raise the feet above belly level with the help of a cushion.
• Exercise – Women who exercise regularly can continue their routine after becoming pregnant, unless advised to do so by the doctor. If vaginal pressure during pregnancy causes discomfort, it is better to avoid strenuous exercises and seek medical advice and explore other options to stay active during pregnancy. Exercises like swimming and walking can help in relieving the pressure from the vagina.
• Belly slings – Increased weight in the abdomen of the pregnant women puts strain on the muscles of the pelvis and back. Belly slings are supportive garments that help in supporting the pregnant belly of the women. These help to reduce the pressure and strain on the muscles of pelvis and back thus helping to manage vaginal pressure during pregnancy.
• Yoga – Performing certain yoga postures can help in relieving vaginal pressure during pregnancy, but it is best done with expert’s advice.
• Warm bath – Lying in a warm bathtub can alleviate muscle stress in pregnancy. It helps to soothe or relax muscles and offer great relief to the pregnant woman. Warm water on the back can also help in relaxing sore muscles.

Vaginal pressure during pregnancy is quite normal. It is however a matter of concern if it occurs during early weeks of pregnancy. The range of discomfort can vary from person to person. If vaginal pressure is felt more like pain and before 36 weeks, immediate medical help must be sought.

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