Pregnancy's Impact on Vaginal Health

Pregnancy affects your vagina and vulva in ways you’re unlikely to expect, from getting what appear to be periods to vulvar varicose veins. And the rest…

What can happen to your vulva and vagina during pregnancy:

Leakage and discharge¹
Swollen labia and vagina²
More orgasmic³
Vulvar colour changes²
Vaginal fluid taste and smell changes⁴
Queefing (vaginal farts)⁵
Pelvic pain⁴
More ingrown hairs²
Varicose veins^6,7
Unexplained bleeding^8–11

Types of vaginal discharge you may see while pregnant

You will experience greater amounts of vaginal discharge while you are pregnant, set off by higher levels of both oestrogen and progesterone. You produce more blood while you are pregnant too, which can contribute to more vaginal discharge due to increased levels of fluids.

Your vaginal discharge, while you are pregnant, will be thin and milky, often increasing over time. If your discharge is not white, thin and milky, you may have an underlying vulvovaginal infection or imbalance that may need treatment.

Bacterial vaginosis, for example, causes a fishy or foul odour and greyish discharge, and a sexually transmitted infection can result in green or yellow discharge. During pregnancy, you may also be prone to yeast infections (thrush).

You can test your vaginal pH during pregnancy with inexpensive pH tester strips which can help keep tabs on flora. Unhealthy flora tend to make the pH 4.5 or higher, while a healthy vaginal pH sits between 3.5 and 4.5.

Vaginal health plays a huge role in your reproductive tract and it’s important that your flora is healthy to help keep the baby put until its go-time.

Vulvar and vaginal swelling

Because of increased blood production, swelling is common during pregnancy. Swelling may appear all over your body, but specifically inside your vagina and your vulva, resulting in a feeling of fullness.

This fullness and increased blood flow may make you feel like sex more often, and result in you being easily turned on. You may not be able to see that your vulva and vagina are more swollen, but you can sure feel it.

Being more orgasmic during pregnancy

As mentioned above, increased blood volume and a sensation of swelling may also result in you becoming more orgasmic during pregnancy³. Each of you will be different, but this can be a fun side-effect of pregnancy.

Vulvar and vaginal colour changes

The extra blood volume may cause your vulva to take on a bluish or purplish hue, known as Chadwick’s sign. This colour change can start to appear at about the six-week mark.

Vaginal fluid change in taste, smell, and pH⁴

Your pH changes a bit during pregnancy, erring on the more acidic side. An acidic vagina tends to be a healthy vagina due to the lactic acid and hydrogen peroxide produced by your lactobacilli, which thrive in an oestrogen-rich environment.

Vaginal secretions may taste or smell a little different, with some research suggesting that during pregnancy, vaginal fluids taste more salty or metallic. The altered fluid has, interestingly, been demonstrated to go away after orgasm.¹

Queefing (vagina farts)

There is no literature on why pregnant women tend to queef more, but they do. It is likely the mixture of changes to the pelvis, which can inadvertently draw air into the vagina, which then must be expelled.^5,12

Stabbing pains in and around your vagina or cervix

As the baby grows, it pushes on certain nerves, causing pains in strange places. These pains are normal, but you should move to a position that is more comfortable to alleviate this type of nerve pain. Check with your doctor if it happens a lot or you are worried.

More ingrown pubic hairs

Your hair may grow faster during pregnancy, resulting in more ingrown hairs.

Varicose veins in your vulva^2,6,7

Varicose veins appearing around the crotch area are common, including within the labia. Vulvar varicose veins aren’t dangerous, but an indicator of stress on your blood vessels as they strain to keep up with downward pressure from the uterus, gravity, and the extra blood production.

Around 10 per cent of pregnant women get vulvar varicose veins, typically appearing in the fifth month. These bulging veins are more likely to occur during a second pregnancy than a first.

Vulvar varicose veins may become uncomfortable, causing a sensation of pressure or fullness. You may find relief from uncomfortable vulvar varicose veins by:

Lying down with a pillow under the buttocks to relieve downward pressure
Lying on the left side
Elevate feet
Use cold packs or cold compresses to contract surface blood vessels, thus shrinking the veins
Take a warm bath
Checking to see if compression garments are suitable for you
Asking your healthcare practitioner for advice

Varicose veins typically disappear on their own once the pregnancy ends and the pressure is relieved. Your blood vessels repair the issue and go back to normal.

Vaginal bleeding while pregnant^8–11

It is common to experience some vaginal bleeding during your first 12 weeks of pregnancy. Any vaginal bleeding in the second and third trimesters needs urgent medical attention.

Implantation bleeding

First trimester bleeding may, very early, be what’s known as implantation bleeding. The implantation is the embryo burrowing into the lining of the uterus (the endometrial lining) to set up its own blood supply.

This burrowing disrupts the uterine lining, and can result in some bleeding. This type of bleeding may be one of your first signs of conception.

Infections

Spotting may indicate an infection, which should be looked into by your doctor.

Unexplained spotting

Some women seem to get spotty ‘periods’ during their pregnancy, which can be a reason why some women completely miss their knowledge of their pregnancies until very late in the game.

Women with irregular periods are the most prone, because irregular periods can mean a period is often quite light or spotty anyway.

Understanding what a miscarriage looks like

Depending on where you’re at with your pregnancy, miscarriage is likely to come with symptoms such as sometimes extremely painful cramping (like a period), bleeding, and foetal tissue passing out of your vagina.

It can be hard to tell the difference between a miscarriage and a heavy period, so keep yourself informed of the warning signs especially if you are an at-risk pregnancy. Any bleeding that is accompanied by cramping needs medical attention.

Understanding what the start of labour looks like

Labour comes with its own set of vaginal fluids, with one of the first signs being pink vaginal discharge. This may be referred to as ‘the bloody show’.

As always, if you have concerns, speak to your doctor.

References

1.
Khaskheli DrM, Baloch DS, Baloch DAS, Shah SGS. Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes. Pak J Med Sci. Published online July 15, 2021. doi:10.12669/pjms.37.5.4187
2.
Kennedy CM, Turcea AM, Bradley CS. Prevalence of vulvar and vaginal symptoms during pregnancy and the puerperium. Intl J Gynecology & Obste. Published online March 9, 2009:236-239. doi:10.1016/j.ijgo.2009.01.024
3.
Polomeno V. Sex and Pregnancy: A Perinatal Educator’s Guide. Journal of Perinatal Education. Published online October 1, 2000:15-27. doi:10.1624/105812400×87879
4.
Marangoni A, Laghi L, Zagonari S, et al. New Insights into Vaginal Environment During Pregnancy. Front Mol Biosci. Published online May 17, 2021. doi:10.3389/fmolb.2021.656844
5.
Veisi F, Rezavand N, Zangeneh M, Malekkhosravi S, Rezaei M. Vaginal Flatus and the Associated Risk Factors in Iranian Women: A Main Research Article. ISRN Obstetrics and Gynecology. Published online May 20, 2012:1-5. doi:10.5402/2012/802648
6.
Gavrilov SG. Vulvar varicosities: diagnosis, treatment, and prevention. IJWH. Published online June 2017:463-475. doi:10.2147/ijwh.s126165
7.
Giannella L, Montanari M, Delli Carpini G, Di Giuseppe J, Ciavattini A. Huge vulvar varicosities in pregnancy: case report and systematic review. J Int Med Res. Published online May 2022:030006052210977. doi:10.1177/03000605221097764
8.
Harville EW. Vaginal bleeding in very early pregnancy. Human Reproduction. Published online September 1, 2003:1944-1947. doi:10.1093/humrep/deg379
9.
Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Patterns and Predictors of Vaginal Bleeding in the First Trimester of Pregnancy. Annals of Epidemiology. Published online July 2010:524-531. doi:10.1016/j.annepidem.2010.02.006
10.
Axelsen SM, Henriksen TB, Hedegaard M, Secher NJ. Characteristics of vaginal bleeding during pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. Published online December 1995:131-134. doi:10.1016/0301-2115(95)02236-8
11.
Hasan R, Baird DD, Herring AH, Olshan AF, Jonsson Funk ML, Hartmann KE. Association Between First-Trimester Vaginal Bleeding and Miscarriage. Obstetrics & Gynecology. Published online October 2009:860-867. doi:10.1097/aog.0b013e3181b79796
12.
Neels H, Mortiers X, de Graaf S, Tjalma WAA, De Wachter S, Vermandel A. Vaginal wind: A literature review. European Journal of Obstetrics & Gynecology and Reproductive Biology. Published online July 2017:97-103. doi:10.1016/j.ejogrb.2017.04.033