Pregnant women can experience groin pain due to several factors, such as hormonal changes, and changes in the structure of the body. Find out more about groin pain and how to manage it.

Pregnancy is the period, when your body undergoes a lot of changes due to the rising levels of pregnancy hormones, like estrogen, progesterone and relaxin. Along with hormonal changes, your body also undergoes some structural changes, and all these can bring about pain and discomfort in the abdominal and pelvic region. So, pain in the groin, lower back, hips, and inside the thighs, are quite common during this period. Groin pain is usually experienced during the second trimester, between 18 to 24 weeks of pregnancy. The pain usually subsides after delivery.

What Causes Groin Pain During Pregnancy
Hormonal Changes
Most of the pregnancy related discomforts including groin pain, can be attributed to the hormonal fluctuations, that take place during this period. A rising level of pregnancy hormones, especially relaxin and progesterone, can cause the muscles and ligaments in the pelvic region to soften and stretch, in order to facilitate childbirth. However, these muscles and ligaments support the joints of the pelvic region and when they become lose, pregnant women can experience pain in the lower abdominal area, groin, and hips.

Structural Changes of the Body
Pregnancy is also characterized by some structural changes of the body, which can result in groin and pelvic pain during this period. The growing fetus, as well as an increase in body weight, can put more pressure on the hips and the pelvic joints. An increase in body weight also alters the center of gravity of the body, which can result in pain and discomfort in the pelvic and the lower abdominal area. Such discomforts can become more frequent, if a correct posture is not maintained.

Round Ligament Pain
Round ligament pain is often described as a sharp and stabbing pain, that can be felt in the hips, pelvis, and the lower abdomen or groin. The round ligaments can be found around the uterus and they are responsible for supporting this organ. During pregnancy, these ligaments stretch and thicken, in order to support and make space for the growing uterus.

All these structural changes can however, produce pain in the lower abdominal area and deep inside the groin. Sometimes the pain can travel up to the hips as well. Pregnant women usually experience this pain, when they get up suddenly from a sitting position and also when they cough, or do an activity, that puts pressure on the round ligaments. Some women can also experience a dull ache in the groin area that can last for a while.

Symphysis Pubis Dysfunction
Pelvis or pelvic girdle is a compound bone structure that consists of four bones, two hip bones, the coccyx (tailbone), and the sacrum (a triangular bony structure located at the base of the spine). The coccyx and the sacrum are joined at the back, while the two hip bones are located at the sides, which then curve around to meet at the front. Symphysis pubis is the fibrocartilaginous joint at the front, where the two halves of pelvis meet. In fibrocartilaginous joints, the bones are joined together by cartilages and fibrous tissues, and this kind of joints permit very little movements or flexibility.

Relaxin and progesterone are the hormones, that prepare the body for childbirth, by softening and relaxing the pelvic ligaments. This allows the pelvic joint to move, so that the baby can pass through the pelvis. Normally, the symphysis pubis joint widens by 2 to 3 mm during pregnancy, to broaden the pelvic ring and facilitate delivery. But sometimes, the pelvic joint moves too far due to overly relaxed ligaments and as a result, the pelvic girdle becomes unstable. This condition is referred as symphysis pubis dysfunction (SPD), and pregnant women may suffer from this condition during their second trimester.

What exactly causes SPD is not known with certainty, though several factors including overproduction of pregnancy hormones, increased load on the pelvic (due to weight gain), and the way the body moves, are believed to have an association with this condition. The area around symphysis pubis can get inflamed, if one side of the pelvis moves more than the other side, while walking or moving the legs. Factors like pelvic trauma, a history of multiple pregnancies, having a large baby previously, and misaligned pelvis, can raise the risk for developing SPD too. SPD can produce intense pain in the pubic and the groin area. Some women can experience pain in the back, hip, and inside the thighs, along with a clicking sensation in the pubic area.

Diastasis of the Symphysis Pubis (DSP)
This condition is related to SPD and is caused by the partial or complete rupture of the symphysis pubis joint, located at the front of the pelvis. This happens, when the pubic joint loosens to such an extent that the gap between the two pubic bones widens abnormally. In women, the average gap in the pubic joint is between 4 to 5 mm, which can increase by 2 to 3 mm during pregnancy. But, if the gap becomes 10 mm or more, the condition is referred as diastasis of the symphysis pubis (DSP), which can produce pain in the pubic area, along with back pain and lower abdominal pain.

Groin Pain Management
The following measures can help pregnant women to manage mild to moderate groin pain.

✓ Always maintain a correct posture.

✓ Wear comfortable low-heeled or flat footwear that can provide adequate support to the pelvic area.

✓ Avoid standing at a stretch for a long time.

✓ Keep your legs slightly elevated while sitting.

✓ While sleeping, try to lie on your sides and keep the knees and the hip bent.

✓ Avoid lifting heavy objects.

✓ Use pregnancy support pillows to get better support.

✓ Include calcium- and magnesium-rich foods in your diet.

✓ Avoid crossing your legs while sitting.

✓ Do mild exercises, like abdominal wall and pelvic floor exercises.

✓ Consider applying heat or ice on the sore area.
If your groin pain is not improving with these measures, then consider visiting your health care provider or an obstetric physiotherapist. The usual treatment options for groin pain include, gentle exercises like abdominal wall and pelvic floor exercises, and the use of pelvic support belt. The physiotherapist can also give a better idea about how to carry out your daily activities, without putting much stress on the pelvis. If the pain is too severe, then your doctor may recommend the use of analgesics. However, make sure that you don't use any medication during pregnancy without consulting your health care provider.

Disclaimer:This article is for informative purposes only, and should not be considered as a substitute for professional medical advice.