Pain between the legs during pregnancy: causes, symptoms, types of pain, treatment and advice from gynecologists

What diseases cause pain in the perineum

If we talk about diseases that lead to pain in the perineum, then among them are:

• The phenomenon of acute as well as chronic prostatitis.
• Inflammatory processes in the urethra.
• Inflammatory processes in the area of ​​the seminal tubercles.
• Inflammatory processes in the testicles.
• The phenomenon of colpitis is inflammation inside the vagina.
• Inflammatory processes at the entrance to the vagina.
• Traumatic injuries to the perineum (including those injuries received during childbirth).
• Pinched nerves in the described area.
• Oncology of the rectum, prostate gland and so on.

Classification of perineal pain

There are several categories of characteristic symptoms when a patient experiences pain in the perineum.

All of them are divided into groups:

• Depending on the cause of pain in the perineal area. Primary discomfort can occur in the presence of neurological abnormalities, and secondary pain occurs when attacks radiate from other organs to the perineal area.
• By type of origin. There is visceral pain, which occurs when nerve receptors are irritated. Psychogenic, formed during the development of pathological processes and functional deviations in the projection area. Neurogenic pain, caused by damage to the innervating nerves in the perineum.
• By the nature of the manifestations. There are paroxysmal or spasmodic pains. The main reasons for their appearance are limited narrowing of the lumen and impaired contraction of tracts.

The temporary duration of pain in the perineum is also divided into several types. Acute attacks manifest themselves as a short-term phenomenon with pronounced pain. While the chronic type can last and develop over several months.

Causes of pain during pregnancy at different stages

Pain and unpleasant tingling in the perineum and lower back in the early stages indicate the development of pathology. The fetus is still small enough to put pressure on muscles and nerve fibers.

Unpleasant sensations arise for the following reasons:

• risk of miscarriage;
• exacerbation of varicose veins due to hormonal changes and thinning of the walls of the veins (is a threat of hemorrhage into the pelvic muscles, disruption of the baby’s blood supply).

Pain in the groin from the 37th week is associated mainly with physiological changes and the gradual movement of the baby’s head down. Discomfort is felt by all expectant mothers, the degree of its severity depends on the characteristics of gestation and health status. Pain and tingling in a later period provoke:

• softening of the pelvic bones;
• compression of nerves in the pelvic plexus;
• sprained joint ligaments;
• increased load on blood vessels, hypotonicity of their walls.

In the crotch

The pain in this case is nagging in nature, occurs on one or both sides, and bothers you in the pubic area. In addition to the above reasons, in the early stages it can be caused by calcium deficiency, pyelonephritis or urethritis. After 36 weeks, the likely cause of discomfort is the high activity of the baby, during which there is pain from the navel to the anus (we recommend reading: what to do if the navel pops out during pregnancy?). Shooting sensations indicate the imminent release of the mucus plug. It can hurt between the legs if a woman, for some reason, doesn’t move much.

In the groin muscles

Why does my groin shoot and hurt? The causes of discomfort may be:

• in the first trimester - the formation of a temporary corpus luteum, which produces progesterone (an important steroid hormone for implantation of a fertilized egg and bearing a child) until the 16th week;
• from week 20 – deficiency of calcium, magnesium, stress on the legs, softening of cartilage.

Pain in the groin is usually sharp or aching in nature. It is especially difficult to bear it at 38-40 weeks, when the baby’s head drops and is at the bottom. This provokes severe stretching of the inguinal ligaments, causing painful discomfort.

In the bones of the pelvic floor

Unpleasant sensations in the area of ​​the pelvic floor bones and abdominal muscles can be caused by the following factors:

• weight gain – leads to additional pressure on the pelvis, which causes pain;
• lack of microelements - the fetus takes magnesium and calcium from the mother, and when there is a deficiency of these useful substances in her body, her teeth deteriorate and her pelvic bones hurt;
• torsion of ligaments – the uterus grows unevenly, which leads to painful torsion of the ligaments that secure it to the pelvic area;
• pathologies of the spinal column - scoliosis and osteochondrosis can cause pain.

During pregnancy, a doctor can diagnose symphysitis - excessive softening, mobility and divergence of the symphysis pubis. Normally, it expands to 5 mm under the influence of the hormone relaxin. With symphysitis, the discrepancy can reach 15 mm. After childbirth, the tissues gradually take their original place. The development of pathology is provoked by genitourinary infections and a lack of cholecalciferol.

In the lower back

Pain in the lower back in the very last weeks of pregnancy is explained by an increase in the weight of the child and an increase in the volume of the abdomen. Naturally, the load on the muscles and bones in the lumbar region increases. With a large belly, the center of gravity shifts forward, which is why the spine is forced to lean back to ensure balance. In this case, there is constant tension in the muscles that hurt. Almost all expectant mothers experience myalgia in the lower back. Those who have suffered back injuries or suffer from kidney pathologies or osteochondrosis are under special supervision.

Nature of pain

We can talk about the diversity of the nature of pain experienced in the perineum. For example, the presence of sharp pain often indicates acute prostatitis. This pain usually radiates to the sacrum, head of the penis, and anus.

Even severe pain in the perineum is caused by acute urethritis and intensifies during urination. Due to abscesses in the prostate gland, there may be sharp pains that will radiate to the sacrum and rectum. It is characterized, as a rule, by unilateral localization, that is, it manifests itself more where the purulent focus is located. In addition, urination becomes difficult, stool retention is noted, and the temperature rises.

In the later stages of cancer, severe pain is also observed. Often the patient is even prescribed narcotic drugs in these cases. Numbness in the inner thigh can sometimes occur due to a pinched nerve.

Finally, all kinds of injuries, including those received by women during childbirth, are dangerous in terms of sharp pain. Other injuries that cause acute pain include bruises, muscle tears, cold wounds, gunshot wounds, and so on.

Do not forget about the concentration of many nerve endings in the perineal area, as a result of which pain can even lead to fainting.

If we talk about nagging and aching pains, they often appear in the case of certain chronic diseases associated with the perineum. For example, the cause may be colliculitis, chronic urethritis or even prostatitis. The pain is felt like a certain burning sensation, is not particularly intense, but can last quite a long time and be constant, that is, reappear from time to time, even if it has disappeared.

Such unpleasant sensations can be accompanied, for example, by cooperitis, when the bulbous-urethral male gland becomes inflamed. This disease is most often considered as a direct complication of urethritis. If purulent processes begin in the gland, the pain intensifies and develops. Postpartum sensations can still be achy due to the fact that the birth canal swells and stretches.

Pain in the vagina

During pregnancy, the ligaments between the legs hurt, but this is not the only pain a woman may experience. She may also experience pain in the vagina. Basically, pain in the vagina occurs only in the early stages of pregnancy. This is due to the fact that the uterus increases in size, and gynecologists consider this phenomenon to be absolutely normal. Such manifestations are observed in almost every pregnant woman. But there are other causes of pain in the vagina, namely:

• Infections. Usually they are manifested not only by pain, but also by itching and severe burning in the perineum, mucous discharge appears, which can also have an unpleasant odor. There is no need to self-medicate, but you should definitely seek help from a specialist who can prescribe the right treatment.
• Vaginal dysbiosis. With the appearance of a future human inside a woman, her body is completely rebuilt, and in connection with this, vaginal dysbiosis quite often occurs. Symptoms resemble an infection: unpleasant odor, burning, itching. Treatment is carried out only under the supervision of a gynecologist, who can also diagnose changes in microflora in a pregnant woman.
• Inflammatory process. If there is some kind of inflammatory process in the vagina, then pain is generally felt only during or after sexual intercourse. A discharge resembling pus may appear, and some experience itching not only of the external organs, but also inside the vagina.
• Ectopic pregnancy. In addition to all the above symptoms, in this case there is added severe stabbing pain in the vagina, which intensifies over time. Severe pain appears in the abdomen, lower back, and bleeding is observed.

Diagnosis for pain in the perineum

If characteristic pain symptoms occur in the perineum, do not panic and delay a visit to the urologist. At the appointment, the doctor will begin by collecting anamnesis and an initial examination with the possible use of palpation. Then a preliminary diagnosis will be made and certain diagnostic measures will be prescribed to confirm it.

The types of tests needed are selected based on the symptoms and individual characteristics of the patient, and may include:

• ultrasound diagnostics of certain organs;
• X-ray of the colon with the introduction of a contrast agent to stain the walls of the bladder;
• endoscopic examination;
• general sampling for laboratory and biochemical studies;
• computed and magnetic resonance imaging;
• microflora smear from the urethra and bacterioscopy.

Thanks to the availability of modern diagnostic equipment in our clinic, all studies will be carried out as quickly as possible with extremely accurate and informative results, on the basis of which the urologist makes a final diagnosis and forms an effective therapeutic course.

Perineal pain in men

Sharp pain in the groin area in men can be characterized by the development of prostatitis, which, in the absence of proper treatment, very quickly becomes chronic and causes irreparable damage to health.

Pain in the perineum in men may be accompanied by certain symptoms:

• feeling of discomfort inside the urethra;
• a sharply descending kidney stone can cause severe pain on the left side of the urethra;
• difficulty going to the toilet, urine comes out in thin streams;
• false urge to urinate;
• the presence of unnatural rashes on the external genitalia;
• burning in the perineum and increased body temperature that cannot be controlled with medications;
• the formation of small hematomas on the perineum, scrotum and thighs.

In such situations, self-medication is completely excluded. Without visiting a urologist, the manifestation of such signs can eventually develop into chronic pathologies, with irreparable consequences for the male reproductive system.

The necessary treatment can be obtained only after completing all the required diagnostic measures, which are aimed at identifying the causative agent of pain in the perineum.

Answers to frequently asked questions:

• How to prepare for an appointment with a urologist?
• How to get tested for urological diseases?
• What tests can be done by a urologist?
• What diseases does a urologist treat?
• What symptoms should you consult a urologist for?
• What diagnostics can a urologist perform in your clinic?
• How to call a urologist at home?
• What urological equipment does your clinic have?
• Urological care in the clinic
• Urological care at home
• How to make an appointment with a urologist at the clinic?

Prevention measures

The following will help prevent discomfort in the groin area:

• wearing comfortable shoes and compression garments (for medical reasons);
• proper nutrition, which eliminates constipation and excess weight gain;
• swimming, yoga classes;
• you should not stand for a long time, especially in the last stages of pregnancy, when your legs swell and hurt (for more details, see the article: what to do if your legs swell in late pregnancy?);
• when sitting, you should not cross your legs to avoid blood stagnation (for more details, see the article: why can’t you cross your legs during pregnancy?);
• the best position for sleeping from week 20 is on the left side;
• compliance with the drinking regime (it is advisable to drink clean still water, unsweetened compotes, weak tea);
• contrast foot baths (as agreed with the doctor).

Typically, pain and slight tingling in the perineum and lumbar area do not pose a threat to the mother and fetus and are a consequence of physiological changes. Massage and exercise will help relieve discomfort. However, there are situations when unpleasant symptoms require urgent hospitalization and medical care. In order not to miss them, it is important for the expectant mother to be attentive to her well-being.

Pain in the perineum in women

Discomfort and pain in women in the perineal area may be accompanied by itching, burning and uncharacteristic discharge from the genital tract, which has an unnatural color and an unpleasant odor. Such signs may indicate the development of a serious disease associated not only with the genital area, but also with adjacent genitourinary organs.

The manifestation of such symptoms may be due to the following reasons:

• mechanical injuries to the external genitalia, including poor-quality douching, unprotected sexual intercourse with the use of foreign objects, improper abortion and curettage;
• the beginning of menstruation in girls with certain malformations of the genital organs;
• ovarian pathologies such as apoplexy, requiring immediate provision of appropriate medical care;
• the presence of foreign bodies in the vagina;
• diseases developing in neighboring organs;
• age-related changes.

It is not uncommon for pain in the perineum in women to be accompanied by gynecological diseases. Therefore, you should not hesitate to visit a doctor; this can lead to serious changes in the reproductive system and the development of chronic pathologies.

Sprain

Quite often, pain between the legs during pregnancy appears already in the last weeks and is a harbinger of the fact that the meeting of mother and baby will take place very soon. During this period, the child begins to slowly put pressure on the ligaments and bones of the hip area, and this causes the mother some discomfort and sometimes pain. This is especially felt if there is an intense sprain of the ligaments. If the muscles between the legs hurt during pregnancy, then gynecologists do not attach any importance to such pain, since it does not pose any danger to either the mother or the baby.

Perineal pain in children

This problem is less common in children than in adults. The most common cause of pain in the perineum in a child is a mechanical injury to the external genitalia. In some situations, an infectious bacteriological lesion occurs.

The main factors influencing the manifestation of such symptoms are:

• failure to maintain daily personal hygiene;
• allergic reactions;
• irritation of mucous membranes with various household chemicals;
• intolerance to certain medications.

In addition to pain in the perineum, boys may experience a change in the color of urine and severe discomfort in the area of ​​the head of the penis. In girls, the characteristic symptoms are accompanied by sharp pain in the lower abdomen and when going to the toilet.

Parents need to listen more carefully to their child’s complaints in order to promptly seek advice from a urologist. In childhood, such manifestations can cause serious complications that will affect the formation of a still fragile organism.

Pubic pain

In the third trimester, many women experience pain in the pubic region. What is the reason for such manifestations? All this can be explained quite simply - this is the physiology of every woman. After all, it is during this period that the pelvic bones move apart to make it easier for the child to pass through the birth canal. But some women feel too much pain, and this is a cause for concern. The main and, perhaps, the only reason for this is symphysitis.

Perineal pain in pregnant women

If pain occurs in the perineum during pregnancy, the woman is in serious danger. Such manifestations may be associated with the development of various infectious inflammations that can affect the organs of the reproductive system and complicate childbirth. Therefore, you should regularly attend scheduled preventive examinations by a gynecologist and report all changes and concerns.

Perineal pain can occur naturally as the baby develops. As the fetus grows, there is strong pressure on the woman’s ligaments and nerve muscles, which stretch and, as a result, discomfort appears. Also, in the early stages, these manifestations can be a signal of a high risk of miscarriage.

Quite often, the fetus can put significant pressure on a nearby nerve. The severe pain that arises from this can even limit movement and will not stop until the fetus changes position.

Severe pain symptoms that occur in the later stages are a sign of imminent labor and are caused by the expansion of the pelvic bones and other accompanying processes as the baby approaches the birth canal.

How to get rid of pain in the perineum during pregnancy

If the doctor finds no deviations from the norm, and a woman has pain in the perineum during pregnancy due to normal changes in the body, she may be advised to perform simple physical exercises and regularly massage the painful area. You don’t need any special skills or specialist help, just follow the following recommendations.

Gymnastics for pain in the perineum during pregnancy

Any physical exercise, including yoga and going to the pool, is allowed only with the permission of your obstetrician-gynecologist. You cannot take such preventive measures on your own, since sports activity has many contraindications during pregnancy.

When your doctor has approved these pain management methods, you can perform therapeutic strengthening exercises, gradually increasing the load. If you have been experiencing a feeling of squeezing for a long time, you have colitis or shooting in the perineum during pregnancy, the following exercises are suitable for you:

• Partial squats - strengthen the muscular system in the perineum, make the tendons stretchable and strong. The exercise is performed like this: lean against the back of the bed, chair or table, spread your legs wide at the knee joints and slowly squat to 90⁰. Since this increases the load on the back, it is recommended to do 6-9 exercises.
• Leg swings - train the muscles of the perineum, making them stretchable. To perform the exercise, grasp the back of a chair and smoothly swing each leg back and forth, left to right. Number of swings: 10 times in each direction. If discomfort occurs in the lower abdomen, the number of times should be halved.

There are many other exercises that are effective when the perineum hurts during pregnancy, but they are performed only under the supervision of an instructor. Women study some of them in preparatory antenatal courses.

Along with the exercises, you can use a special bandage for pregnant women. It will hold your tummy in the desired position.

Perineal massage during pregnancy

The perineum is a collection of muscle tissue and skin. Its purpose is to close the entrance to the lumen of the pelvic organs. In order for a woman to feel comfortable during pregnancy and not suffer multiple tears during childbirth, it is important to maintain the elasticity of all soft tissues.

In many women, especially first-time mothers, the perineum is quite elastic and unyielding. For this reason, in women, pregnancy is accompanied by cramps in the perineum. Special massage helps to significantly reduce pain, maintain the integrity of the perineum and prevent episiotomy during childbirth. You can do it yourself in the first trimester and with the help of your husband or massage therapist at a later date.

It is better to do a massage after a warm shower, which helps relax smooth muscles. If this is not possible, you can apply a warm compress to the perineal area for 7-8 minutes.

After this, take a reclining position, place a large pillow under your back. If you cannot reach the perineum due to a large belly, you can perform the procedure while standing. Then apply oil to your hands, the vestibule of the vagina and most of it. To do this, you can use calcined vegetable oil or special oils for intimate massage. To enrich the composition, you can add rose essential oil, wheat germ, apricot kernels, and a liquid solution of tocopherol (vitamin E).

It is prohibited to perform such a massage if you have any gynecological diseases of an infectious nature.

Perineal massage can be done at any gestational age. In the first trimester, it is permissible to conduct 1 session per week, from 28 to 32 weeks - 3-5 times a week, starting from 36 weeks until delivery - every other day. If you are 38 weeks pregnant and your perineum hurts very badly, you can massage it daily.

How to massage the perineum:

1. Gradually insert the thumbs of both hands into the vagina to a depth of 3-4 cm. Using squeezing movements, move your fingers slightly down and to the sides. The duration of the procedure is 60-90 seconds. In this case, there should be a slight burning sensation under the fingers.
2. Insert your fingers into the vagina 2 cm and begin to stretch it to the sides. You can massage one finger at a time in each direction if you cannot reach properly. Perform 10-15 stretches in each direction.
3. Insert your finger 3 cm deep and make upward movements, slightly stretching the vaginal walls. Perform a massage for 3-4 minutes.

Important! An intimate massage should be performed with clean hands with trimmed nails (sterile gloves can be used). At the same time, it is important to cleanse the intestines and relax.

Now you know why the perineum hurts during pregnancy. As you can see, there is no particular cause for alarm, so do not worry unnecessarily. And if you have any doubts, be sure to consult your gynecologist.

What tests are done for pain in the perineum?

At the initial stages of the study, it is important to quickly identify the causative agent of emerging pain in the perineum and correctly make a diagnosis with further prescription of a course of therapy.

Based on this, the urologist, after collecting a history and visual examination of the patient, prescribes the most specific series of tests:

• blood sampling for biochemical analysis to identify the chronic stages of certain pathologies;
• scraping of epithelial cells;
• a general urinalysis, which examines the white blood cells passing through the urethra and excreted in small quantities during urination;
• bacterioscopy for women;
• superficial smear from the urethra for microflora in men.

If you suspect the presence of infections that are transmitted through sexual contact, additional tests may be prescribed, such as donating sperm and prostate secretions.

During laboratory diagnostics, the presence of prostatitis in men is first checked, and cystitis is detected in women. This approach eliminates possible infection of neighboring organs. If testing is not enough to obtain the necessary information about the pathogen, additional hardware examinations are prescribed.

Methods for diagnosing urological diseases:

• Calling a urologist to your home
• Diagnosis of kidney diseases
• Diagnosis of bladder diseases
• Diagnosis of prostate diseases
• Diagnosis of scrotal diseases
• Diagnosis of sexually transmitted infections
• Urine tests
• Tests for STIs
• PSA tests
• Ultrasound at home
• Kidney ultrasound
• Ultrasound of the prostate
• Ultrasound of the bladder
• Urological ultrasound at home
• Urethral swab
• Ultrasound of the penis
• Transrectal ultrasound
• Prostate juice tests
• Ultrasound of the genitourinary system

Ultrasound for pain in the perineum

Ultrasound diagnostics is a completely safe way to examine the pelvic organs to determine the causes of pain in the perineum. The study is based on the reflection of waves of a certain frequency from tissues and other organs.

Using ultrasound, it is possible to identify the presence of various pathologies and identify unnatural compactions in tissues. The procedure for conducting an abdominal examination is as follows:

• the patient lies down on the couch, having previously undressed to the waist and lowered his pants;
• the doctor applies a special gel to the area of ​​the body being examined to make the sensor glide more freely;
• then the device is moved from side to side over the skin for 10-15 minutes;
• all results are displayed on the screen and recorded in the protocol.

Based on the information received, the urologist is able to determine the cause of pain in the perineum and create the most effective treatment method, taking into account the individual characteristics of the patient.

Which doctor should I contact for pain in the perineum?

A urologist deals with the prevention and treatment of diseases that arise from pain in the perineum. The doctor’s responsibilities include collecting anamnesis at the initial appointment, visual examination of the groin area and subsequent referral to undergo the necessary diagnostic measures with accompanying laboratory tests.

Based on the patient’s age and gender, various research methods can be prescribed and individual courses of therapy can be drawn up:

• non-steroidal drugs are prescribed in the presence of inflammatory processes in the urinary system;
• hormonal drugs are prescribed to pregnant women to improve the health of the body;
• vitamins help maintain weakened immunity, which is caused by developing pathology;
• Antibiotics are the main method of drug treatment.

Perineal pain cannot be ignored. Such manifestations require immediate contact with a urologist to receive appropriate medical care. Our clinic employs a doctor with many years of experience who is able to correctly diagnose the cause of pain and create the most effective course of therapy.

How to relieve pain and carry out prevention

To avoid pain in the pubic region, gynecologists recommend the following:

• Do not go for too long walks, if possible avoid climbing stairs.
• You can purchase a special bandage at the pharmacy that will reduce pain during symphysitis and make it easier for a pregnant woman to move.
• While standing, it is not recommended to put all your weight on just one leg.
• Periodically you need to change your sitting position and during pregnancy, you need to try not to cross one leg over the other.
• Do not forget to visit a gynecologist, who in the last weeks will prescribe medications that will reduce pain; it is also recommended to undergo UV irradiation.

Where to go for pain in the perineum

An experienced urologist from our clinic is ready to conduct an examination on any day convenient for the patient and refer him for further hardware diagnostics.

To understand when you need to seek medical help, you need to know the reasons that cause pain in the perineum:

• prolonged hypothermia of the body;
• mechanical injury to the groin area;
• intestinal obstruction;
• inflammation of the lymph nodes located in the pelvic area;
• osteochondrosis;
• inguinal hernia;
• tumors of malignant and benign nature;
• previous operations on the urinary system.

People who experience acute pain symptoms in the perineum are susceptible to severe stress. Our clinic offers completely anonymous treatment, without disclosing personal information provided by the patient.

Make an appointment with a urologist by phone or by filling out the online form

Causes of pain

Any pain in a woman’s groin is caused by various pathologies. Very often, pain is accompanied by increased body temperature, bloating, intestinal dysfunction, and general weakness. The most common causes of pain in this area include:

• inflammatory processes of the genital organs - adnexitis, oophoritis, salpingitis;
• the presence of stones in the kidneys and urinary tract;
• rupture of an ovarian cyst - accompanied by sudden, acute pain;
• ectopic pregnancy - the pain is sharp, paroxysmal, and increasing in nature;
• diseases of the urinary system (urethritis, cystitis, bladder injuries);
• appendicitis;
• diseases of the digestive system (chronic constipation, intestinal obstruction);
• inguinal hernia;
• osteochondrosis – pain in the lumbar region radiates to the groin;
• inguinal lymphadenitis – inflammation of the lymph nodes;
• pathology of the hip joint (arthritis).

The list of pathologies in which groin pain is a symptom can be continued. For a more accurate diagnosis, the location of pain and the characteristics of its manifestation are important.

Calling a urologist at home for pain in the perineum

Not all people have the opportunity to visit the clinic on their own if they experience pain in the perineum. In such situations, it is worth taking the opportunity to call a urologist at home, where an examination will be carried out in the usual home conditions.

In order to save time, it is recommended that patients of the following categories pay attention to this service:

• older people who have difficulty traveling independently on public transport;
• patients with physical limitations in mobility caused by mechanical injuries or surgical intervention due to surgery;
• people who have a limited amount of free time at their disposal.

You can call a urologist at home by simply calling the specified phone number with a description of the problem or submit an application on the official website of the clinic.

Publication date 2019-12-04

Common symptoms and manipulations in urology:

• Pain when urinating
• Discharge from the urethra
• Itching in the urethra
• Short frenulum of the foreskin
• Prostate massage
• Prevention of casual sex
• Frenum plastic surgery
• Circumcision
• Kidney pain
• Perineal pain
• Stones in the kidneys
• Pus in urine
• Catheter removal at home
• Bougienage of the urethra
• Urinary retention
• Urological examination
• Papillomas on the foreskin
• erectile disfunction
• Make an appointment with a urologist

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

Answers to questions on the topic: Pain in the perineum