Written by Jessica McKinney, PT, MS and Samantha Pulliam, MD and sponsored by
It’s no surprise to you that pregnancy puts your body through lots of changes. Some of these changes can be seen and felt ‘down there.’
Let’s get some terminology straight. People often refer to the vagina, when they really mean the vulva – the outside, visible part of the female genitalia. It includes: the vaginal opening, the urethral opening (where urine exits the body/pee comes out), the labia majora and labia minora (the outer and inner lips, which protect the openings of the vagina and urethra), and the external part of the clitoris, called the glans clitoris. The vagina is the inside part of the female genitalia. It’s a flexible tube that connects the uterus, or womb, to the vulva.
During pregnancy, your total blood volume – the amount of blood in your body – increases by 30-50%. This, along with a rise in hormone levels of estrogen and progesterone, lead to increased blood flow to the vulva and vaginal area. This can cause the vulva to become swollen. You or your partner may also notice changes in the skin color of the vulva and around the vaginal opening, usually a darker or more heightened color than what you may have noted pre-pregnancy. You also may note the appearance of varicose veins in the vagina or vulva, or experience hemorrhoids in the anus or rectum. If these are bothersome, talk with your health care provider about treatment options, which may include support or compression garments, or other interventions.
With the increase in blood flow and pregnancy hormones, you may also see some changes in vaginal discharge. Normally, vaginal discharge is clear or white in color. It consists mostly of water and healthy bacteria that keep the vagina acidic. The acidity prevents too much growth of unhealthy bacteria or yeast. Hormonal changes during pregnancy can alter the acidity of the vagina.
The change in acidity makes you more prone to yeast infections. In fact, there’s a 10-20% increased risk of yeast infections during pregnancy. If you experience itching, burning, or discomfort or notice a strong or unpleasant smell or any changes in color, amount or consistency of vaginal discharge, call your healthcare provider.
It’s helpful to know what changes are normal and when it’s important to talk to your health care provider. It’s also helpful to know that for most women all of these changes gradually return to baseline over six to twelve weeks after pregnancy.
About the authors:
Ms. McKinney is a physical therapist and has specialized in pelvic and women’s health throughout her career. Her background includes women’s health education, advocacy, and business and program development in the US as well as in low-resource global health settings. She currently serves as Vice President of Medical Affairs and Clinical Advocacy at Renovia Inc.
Dr. Pulliam a fellowship-trained and board certified urogynecologist, a subspecialty of medicine focused exclusively on female pelvic health. She has been in clinical and leadership positions at Massachusetts General Hospital and the University of North Carolina (Chapel Hill), as well as within the American Urogynecologic Society, and she currently serves as the Chief Medical Officer at Renovia Inc.
- Moore K, Dalley A, Agur A. Clinically Oriented Anatomy. Lippincott Williams & Wilkins; 2013.
- Tan EK, Tan EL. Alterations in physiology and anatomy during pregnancy. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):791-802. doi:10.1016/j.bpobgyn.2013.08.001.
- Farage M, Maibach H. Lifetime changes in the vulva and vagina. Arch Gynecol Obstet. 2006;273(4):195-202. doi:10.1007/s00404-005-0079-x.
- American College of Obstetricians and Gynecologists. Vulvovaginal Health. Freq Asked Quest FAQ190 Women’s Heal. 2015. https://www.acog.org/-/media/For-Patients/faq190.pdf?dmc=1&ts=20190118T2109581063. Accessed January 18, 2019.
- Polomeno V. Sex and pregnancy: a perinatal educator’s guide. J Perinat Educ. 2000;9(4):15-27. doi:10.1624/105812400X87879.