5 Causes Of Pelvic Pain In The 1st Trimester, According To Experts
Pelvic pain is common during your first trimester, but then again so is nausea, and just because these feelings are normal doesn’t make them any less unpleasant. Your pubic bone is softening and the uterus is enlarging in early pregnancy to make room for the baby, but there are other causes of pelvic pain in the first trimester.
“When you think of how much is happening inside the uterus during the early stages of pregnancy (the embryo has to implant, burrow its way into the lining of the uterus and hook itself up to mom's circulatory system) it makes sense that there will be some cramping here and there,” Dr. Lucky Sekhon, reproductive endocrinologist and infertility specialist, tells Romper. You will normally feel cramps or twinges during the first eight to 12 weeks of pregnancy, which is sometimes called “accommodation pain.”
Accommodation pain is "usually a dull, throbbing sensation or cramping that doesn't ease when you change positions,” per Self. Your body is going through a ton of changes including increased fluid volumes, a growing uterus, and increases in hormone levels which impact your joints and ligaments, as Dr. Angela Jones, OB/GYN tells Romper, so there is bound to be at least some discomfort. Read on for five causes of pelvic pain during the first trimester, and how to know when the “normal” discomfort is actually something you should mention to your doctor.
1. Round Ligament Pain
Ligaments connect bones to other bones and joints, and they're responsible for tethering the uterus to the groin.
"Round ligament pain [is] usually characterized as sharp, and noted primarily in the groin region," Jones tells Romper. "It's caused by tension put on the 'round ligaments,' the major suspensory ligaments of the uterus, as they support a growing uterus."
2. Implantation Pain
Not everyone will experience implantation pain, (per Healthline) which can cause a cramping sensation when the fertilized egg attaches itself to the uterus. In some cases, this may also cause bleeding.
"Sometimes the embryo will invade into a small blood vessel as it is implanting, which can cause some 'implantation bleeding,'" Sekhon says. "The uterus tends to cramp when there is blood as it is an irritant." This bleeding can be alarming, especially if you suspect that you're pregnant, but it's nothing to be concerned about. It will typically last one to two days, or as little as a few hours, and will generally look like light spotting.
3. Urinary Tract Infection
Typically you'll experience frequent urination and an accompanying burning sensation with UTIs, but pelvic pain can be a symptom. "Urinary tract infections can be pretty serious in pregnancy," Jones tells Romper. "Left untreated, they can cause pyelonephritis, when the infection ascends from the bladder to the kidneys." She adds that this has the potential to cause sepsis, hospitalization, or even potentially preterm labor. If you think you have a UTI, go to your doctor as soon as you can. It's no big deal when they catch it early, and it can be quickly treated with a pregnancy-safe antibiotic.
I know, I know, it's annoying when you say your stomach hurts and someone asks, "well, have you pooped?" so apologies in advance, but constipation in early pregnancy is a common cause of cramping or pelvic pain.
"The elevation in hormone levels, specifically progesterone, that is seen in pregnancy causes the bowels to slow down," Jones tells Romper. "This in turn causes constipation which can be associated with cramping or flat out pain." If you're constipated, you can try drinking more water, eating fiber, and getting some exercise. If that doesn't get things moving, stool softeners are also generally considered safe for pregnancy, per The Mayo Clinic, but always check in with your doctor first.
5. Uterine Fibroids
"Uterine fibroids can be asymptomatic or cause pain during the course of a pregnancy," Jones tells Romper. "Fibroids are hormonally-responsive, [meaning] they will grow in response to elevated levels of estrogen and progesterone, both of which are present during pregnancy." She adds that fibroids may degenerate (this means they outgrow their blood supply and die), which can cause significant pain during a pregnancy.
When Should I See My Doctor For Pelvic Pain In The First Trimester?
Even if you know that pelvic pain is normal during early pregnancy, it can still cause anxiety. You should always feel comfortable to check in with your doctor if anything, no matter how small, feels off. Dr. Sekhon tells Romper it's especially important to check in with your doctor if your pelvic pain is, "accompanied by vaginal bleeding, associated with a fever or feeling unwell, or severe and not responding to over-the-counter pain medication (Tylenol 650 milligrams every four hours as needed)."
Dr. Angela Jones, OB/GYN