Uterine pain in early pregnancy is common and indicates your body is preparing for the pregnancy. The pain may be due to several reasons, such as stretching the uterus or hormonal changes. You are also likely to experience low-back or pelvic pain due to these changes. The pregnancy journey is accompanied by significant physical changes, some of which are natural to maintain a healthy pregnancy. However, it is essential to understand the symptomatic difference between the pains since some may indicate complications such as ectopic pregnancy or miscarriage.
Learn about the common causes of uterine pain in early pregnancy, when to worry, and the treatment management.
When Does Uterus Pain Start In Pregnancy?
What Causes Uterus Pain In Early Pregnancy?
Some possible causes of uterus pain in early pregnancy include:
- Stretching of the uterus: As you reach the 12th week of pregnancy, you may feel uterus pain as it expands out of the pelvic area to the size of a grapefruit. The stretching may be accompanied by symptoms such as period-like cramps and mild spasms. In twin or multiple pregnancie, the stretching of the uterus may begin earlier, and hence you can feel the pain before 12 weeks (2) (3).
- Gas or constipation: The increased progesterone level in the body is one of the primary reasons for gas or constipation during pregnancy. The hormone induces increased relaxation of the intestinal muscles resulting in slower digestion. Thus, the bowel movement through the intestinal tract slows down by 30%, allowing gas to accumulate (4). The symptoms are similar to stretching the uterus and generally do not cause severe discomfort.
- Round ligament pain: The connective tissues in the pelvis attached to the uterus are called round ligaments. When the uterus begins to expand, these ligaments tend to resist the pull, causing the pain. You may feel a sharp pain on both or either side of the lower pelvic area (5).
- Pelvic floor pain: A pelvic floor consists of muscles, connective tissues, and ligaments that lie beneath and support the bladder, rectum, uterus, and vagina (6). Pain in the vagina, bladder, abdomen, back, or near the uterus indicates pelvic floor pain. Commonly, it may be masked as uterine pain due to the expansion of the uterus or the relaxin hormone. The hormone produced enables relaxation of the uterine wall while giving birth and can induce pelvic pain in early pregnancy (7).
When To Worry?
In most cases, the uterus pain you feel during the first trimester may not be harmful. However, some specific concerning symptoms could indicate a complication.
- Miscarriage: In every pregnancy, there is a chance of miscarriage, and if they do occur, it is likely to happen before 20 weeks of pregnancy. Therefore, if the pain does not go away or persists for longer periods and is accompanied by bleeding, sudden cramps, vaginal spotting, or low-back pain, it may be a miscarriage (7) (1).
- Ectopic pregnancy: At times, the fertilized egg may get implanted outside the uterus, such as in the fallopian tubes, resulting in an ectopic pregnancy. In such a case, you need to watch out for signs such as severe pain on either side of the lower abdomen, bleeding, dizziness, or difficulty in passing stool or urine (7) (1).
- Ovarian torsion: The presence of the corpus luteal cyst during the first trimester that helps support the pregnancy may sometimes overgrow, causing the ovaries or the fallopian tubes to twist on the surrounding tissues. This is called ovarian torsion, which may occur between the sixth and 14th weeks of pregnancy (8). You may experience severe pain with vomiting, dizziness, and sudden cramps that can continue for days to even weeks. The torsion prevents the blood supply to the ovaries and requires medical assistance (9).
How To Treat Uterine Pain In Early Pregnancy?
An ultrasound, hCG blood test diagnose pain, or both depending on its symptoms and severity. Accordingly, the treatments will vary, such as if an ovarian torsion or ectopic pregnancy is detected–surgery is the only option to prevent further complications (2) (7).
- Drink plenty of water and fiber-rich foods to prevent and manage gas and constipation.
- Relax with a warm bath or use a heating pad, ensuring it is not too hot.
- Switch between sleep positions–lying on your back and sleeping on your side with a pillow to support your belly.
- Incorporate pregnancy-safe exercises that involve light stretching in your routine.
- Massage the pain area gently without putting too much pressure on it.
- Keep your knees close to your chest to take the pressure off your uterus.
Frequently Asked Questions
1. How can I feel my uterus in early pregnancy?
You can feel your uterus by touching your growing belly
2. Can I feel the uterus stretching at four weeks?
In the first few weeks of pregnancy, the uterus does not go through any expansion or other significant changes. It is only around the 12th week that you may experience the uterus stretching with mild pain.
- Uterine pain in early pregnancy is caused by stretching of the uterus, gas, or round ligament pain.
- Sometimes the pain may be accompanied by other symptoms indicating complications such as a miscarriage or ectopic pregnancy.
- Immediate medical assistance is required for signs such as bleeding, vomiting, or severe persistent pain.
- Stomach (abdominal) pain or cramps in pregnancy.
- When should cramps during pregnancy be worrisome.
- Uterus size during pregnancy.
- Pregnancy gas.
- Growing pains during pregnancy are normal.
- About pelvic floor disorders.
- Uterus pain: Learn about the causes and treatment in early pregnancy.
- Randall Young and Kelly Cork (2017). Intermittent Ovarian Torsion in Pregnancy.
- Ovarian torsion.