Pregnancy affects sexual activity and orgasms for the majority of women. According to studies on the effect of pregnancy on sexual function, most pregnant women will experience fewer orgasms during pregnancy than before, but this is not the case for all women.
Fewer and Less Intense Orgasms
Most pregnant women will have fewer and less intense orgasms, according to a review article on sex and sexuality in pregnancy in the Global Library of Women's Medicine. Results vary, but most studies found that the majority of pregnant women experience a decrease in sexual desire and sexual activity and orgasms. The following studies illustrate this conclusion:
- An early study of 260 pregnant women reported in the New England Journal of Medicine in 1973 found a progressive decrease in sexual function and the frequency and intensity of orgasms for most women. A small percentage of women in this study noted an increase or no change in orgasms during pregnancy.
- Another study in the British Journal of Obstetrics and Gynaecology in 1981 found that of 119 pregnant women, most had a decrease in sexual activity and orgasms.
- In the journal Health, a study of 111 pregnant women found that women reported having difficulty with orgasms on the average 19% of the time before pregnancy and this increased to 43% of the time by the 38th week of pregnancy.
- A 2007 study reported in the Journal of Sexual Medicine showed that 81% of pregnant women reported difficulty achieving orgasms, whether through intercourse, partner manual or oral stimulation, or masturbation.
- A study reported in the same journal in 2014 found that the decrease in sex and orgasms happens progressively throughout pregnancy so that by the third trimester, the frequency of orgasms was much less than pre-pregnancy levels for most women.
Though most studies found that the decrease in sexual activity and orgasms was progressive through the three trimesters, two studies found that this occurred less frequently during the second trimester. One study was published in the Archives of Sexual Behavior in 1991 and the other in the cited 2007 study in the Journal of Sexual Medicine.
Many studies reviewed included only a small number of women, which limits the quality of the studies so larger and better designed studies are needed.
Causes of Decreased Sexual Desire and Orgasms
Several factors can explain the decrease in sexual activities and orgasms in pregnant women. These include physical, marital, cultural and religious barriers and a lack of information or misconceptions about sex or orgasms during pregnancy and their effects on a baby.
The following is a list of specific influences on pregnant women's sexuality and ability to have an orgasm:
- Avoidance of sex or a subconscious repression of orgasm because of couple's fear that either will hurt the baby
- A fear of miscarriages , premature labor or rupture of membranes, especially in women who had pregnancy difficulties in the past
- First trimester symptoms, such as fatigue, nausea, vomiting, or breast tenderness
- Fatigue, mainly in the first and third trimester
- Second and third trimester physical issues including increasing size of abdomen and breasts, weight gain and discomforts of pregnancy
- Urinary frequency and urgency can cause discomfort in the pelvis and vagina and inhibit interest or relaxation during sexual activity
- Some women may find the blood congestion of the vaginal and vulvar tissues to be uncomfortable or painful and that this inhibits sexual activity and orgasms
- Decreased interest in sex (libido) as pregnancy progresses, leading to decrease in arousal and engorgement and therefore orgasms
- Sexual activity/positions become uncomfortable or awkward closer to term, inhibiting a woman's ability to reach an orgasm
- A woman's change in her body image as her pregnancy progresses
- Cultural or religious biases against sex during pregnancy
- Perception that the baby is a third party in the sexual activity, especially after he starts to move in the second trimester
- Stress and ambivalence about becoming a parent
- Marital tension between a couple because of the stresses of pregnancy or other sources of stress, causing a woman to avoid sex or have difficulty reaching an orgasm
- Change in the male partner's attitude towards his pregnant partner's sexuality, leading to decreased intimacy between the couple with negative effect on the woman
- The male partner's fear of being displaced by the baby, which leads to decreased intimacy and sexuality and increased sexual dysfunction between the couple
Couples may not consciously recognize that these factors are at work and may blame the changes in sex and orgasms on the pregnancy itself. While pregnancy may have a negative impact on a male partner, there are no studies on the effect of pregnancy on the orgasmic function of a man.
Enhanced Sexual Responsiveness
Because of normal physiologic changes during pregnancy, a small percentage of pregnant women may find it easier to be aroused and have a more enhanced sexual response and more frequent and intense orgasms. Pregnancy causes more blood to flow to the uterus and other pelvic tissues to support the growing baby; therefore, the vagina and labia are more swollen throughout pregnancy. As a result some pregnant women may stay in a constant state of partial engorgement and sexual arousal and want to have sex more often.
More Frequent and Intense Orgasms
The increased arousal gives some pregnant women the potential to have more frequent and intense orgasms and some may even have their first one during pregnancy.
During sexual activity, the veins in the pelvis, vagina and labia become more congested and engorged with blood than in non-pregnant women. This engorgement includes the muscles surrounding the vagina, anus and urethra which contract during an orgasm. For the pregnant women who reach an orgasm, these engorged muscles contract more forcefully before relaxing, causing a more intense orgasmic experience.
Effect of Orgasms on the Pregnant Uterus
During an orgasm, there are contractions of the muscles of the pelvic floor and uterus, and your abdomen may feel harder. These uterine contractions are not those of labor, however, and do not initiate labor. Your baby is also well protected during sex and orgasm by the muscular wall of the uterus and the cushion of the amniotic fluid.
In addition, although oxytocin secretion increases during sex and orgasm, it doesn't trigger contractions in a uterus not yet primed for labor.
An orgasm may tighten the ligaments that attach the uterus to the abdominal floor as the uterus contracts. This tightening together with the uterine contractions may be perceived as pelvic cramping, especially if the orgasm is intense. These cramps should subside within a few minutes. If they don't, or if there is pain which continues, increases or returns after stopping, consult your doctor or midwife to make sure you are not in labor.
Risks of Orgasms on Pregnancy Outcome
Unless you have a medical problem or a high risk pregnancy reason that prohibits intercourse completely, having an orgasm during pregnancy carries no risks for you or your baby. This conclusion is contrary to conflicting advice and misconceptions that women and their partners may have. Though most studies look at sex during pregnancy and not specifically at orgasms, the consensus is that neither sex nor an orgasm cause adverse outcomes in low risk pregnant women.
- A study in the Singapore Medical Journal showed that sex and orgasms did not increase the chance of initiating spontaneous labor at term and neither lead to poor pregnancy outcomes.
- Another study published in the journal Obstetrics and Gynecology found that women 29-36 weeks pregnant who had orgasms were less likely to deliver preterm.
- An earlier study in Lancet found that sex did not lead to an increase in premature rupture of membranes, low birth weight, intrauterine or newborn death.
Information and Discussion
Despite an increase in blood flow to sexually-responsive tissues, most women report that their sexual activity, sexual responsiveness and orgasms decrease during pregnancy. Fewer women note no change, or an increase in their orgasms.
Some women will be able to overcome the factors that lead to a decrease in their orgasms. Before you get, pregnant have an open discussion with your doctor and your partner about potential barriers to sex and sexuality during pregnancy to help you cope with them once you are pregnant.