A 22-yr. female writes from Pakistan:

Hi. 2.5 months have passed since my pregnancy. Here are my questions: (i) Should there be penis insertion into vagina during pregnancy at all? (ii) Nowadays, since sometime, whenever insertion is there, I feel burning in my vagina upon penis entrance and it spreads as it goes further inside. (iii) I also feel that vagina has limited, or sometimes even no space for holding the penis. (iv) Abdominal pain also starts upon penis entrance. Local gynacologist says that its because of lack of proper water intake during pregnancy but her answer does not satisfy me. (v) Since pregnancy, I also have not felt discharge during intercourse, and satisfaction level has also reduced considerably. Does sexual desire reduce in pregnancy? (vi) We both think that psycologically we are quite depressed over not being able to insert. Does that happen to all? (vii) Since pregnancy, there is stress in buttocks which continues in backbone and legs.

Thank you for your mail. It's my pleasure to clarify your questions.

i) It is alright to have intercourse (insertion of penis into vagina and thrusting) during pregnancy. HOWEVER the thrusting should not be fast / deep. The thumb rule is there should not be any pain, inconvenience, weight etc. on you. Positions in which deep penetration is not possible are better during pregnancy, especially as the tummy gets bigger and bigger.

Side to side position of intercourse in which husband lies behind the woman (woman has to fold her legs slightly to permit penetration) is a frequently recommended position for pregnant women, as this is both safe and satisfying.

ii) Burning in vagina during penetration is common during pregnancy because during pregnancy, the vagina harbors and fosters growth of the yeast called CANDIDA. As a result of this there is increased white discharge, some vaginal redness, itching, and burning sensation during insertion. Nothing to worry, since this is common during pregnancy. Your gynecologist will be able to prescribe a suitable safe medication / topical application to clear this.

Another reason for the burning sensation is decreased lubrication during pregnancy. You may use lubricants such as KY Jelly. If the problem persists, in spite of using KY jelly and in the absence of vaginal candida infection, you need to get examined for other vaginal conditions. However the first 2 conditions are most common.

iii) As the baby inside you grows, the moth of the uterus pushes itself more into the vagina and therefore you will feel that the vaginal space is decreasing ("limited" as you called it). In the coming months you may feel that the penis is touching/hitting it. (That is why we suggested the above coital positions).

iv) Abdominal pain on insertion of penis is different from the pain you get on his thrusting. If you experience abdominal pain during intercourse, I strongly suggest that you change the coital position immediately and try the method I suggested above. Try it for a few times. If the pain does not disappear, I think it is wiser to avoid sex for a few days/weeks.

v) Yes. Sexual desire, & lubrication (what you called 'discharge') diminish during pregnancy, because of hormone changes during pregnancy. The same may be the case too when you breast-feed your baby.

vi) Please do not be upset by not being able to enjoy sex during pregnancy. It happens to millions of couples. But at a time when you are experiencing another wonderful phenomenon of childbearing, is sex not worth waiting for a while? Show your love and affection to your husband in many other ways. Hugging, kissing, caressing, helping him reach orgasm in other ways acceptable to you both.

vii) Yes, during pregnancy there will be stress on the back, legs and the buttocks. Talk with your family physician about how to minimize this.