Round Ligament

What is the round ligament?

Round ligaments are ropelike bands of connective tissue that support your uterus. There are two round ligaments of the uterus, one on either side. Each is about 4 inches (10 centimeters) long. Round ligaments typically don’t contribute to any health problems, but they can overstretch and cause pain in your groin area during pregnancy.

The round ligaments develop from the gubernaculum, which is a tissue you can find in all fetuses during fetal development. When sex organs form, the round ligament of a fetus assigned female helps connect the uterus to the outer lips of the vagina (labia majora). In a fetus assigned male, the ligament moves down to its scrotum (sac that holds the testicles).

When people refer to “round ligaments,” they generally mean round ligaments of the uterus. Another round ligament, the round ligament of the liver, is what remains of the umbilical vein. This blood vessel carries blood from the placenta to the fetus during pregnancy.

What are ligaments?

Ligaments are strong bands of fibers interconnected in strong, cordlike ropes. Typically, ligaments attach bones in a joint. In places like your elbow, ligaments make crisscross connections that help stabilize the joint and help it move. Other ligaments, like the round ligament, help support your internal organs. Rather than connecting bones to stabilize a joint, the round ligament supports your uterus and connects it to the lower part of your abdomen.

What is the purpose of the round ligament?

The round ligaments exist to support organs in your pelvis. In people assigned female at birth (AFAB), round ligaments support and anchor the uterus.

During pregnancy, the round ligaments are put under a lot of tension. They get wider and longer to support your uterus as it grows to accommodate a fetus. This tension can cause pain that radiates through your entire groin area.

Do men have round ligaments?

Yes, people assigned male at birth (AMAB) have round ligaments. Round ligaments typically don’t cause pain or health complications in people AMAB, so people may not know they exist.

Where is the round ligament located?

There are two round ligaments, one on each side of your uterus.

Several structures come off the top corners of your uterus and briefly run together: the round ligament, the fallopian tube and the ligament that holds your ovaries close to your uterus. From there, the ligament enters your abdominal wall and travels through your groin (in the inguinal canal), and eventually inserts into the labia (vaginal lips). This is often why pregnant people experience round ligament pain in their vaginal area.

What conditions affect the round ligament?

Several conditions can affect the round ligaments during a person’s reproductive years. These include:

• Round ligament pain: Round ligament pain is a common pregnancy symptom as ligaments stretch and contract. It can start in the second trimester of pregnancy (after 13 weeks). You may experience sharp pain in your hips, abdomen or vagina.
• Round ligament varicosity (RLV): Varicose veins can develop in the veins of the round ligament during pregnancy, most often in the second trimester. RLV can cause pain and swelling in your groin area. People sometimes mistake the condition for a hernia. Your healthcare provider should monitor RLV throughout your pregnancy. It generally resolves on its own after delivery.
• Endometriosis: This condition causes cells similar to those in your uterine lining to grow outside your uterus. In some cases, endometriosis develops in or on the round ligaments. Endometriosis can lead to pelvic pain.

Why does pregnancy cause round ligament pain?

During pregnancy, your uterus grows and expands to accommodate a fetus. (Your uterus starts about the size of an orange and by the end of a pregnancy, it’s about the size of a watermelon.)

The round ligaments also expand to support your uterus as it gets bigger and heavier throughout pregnancy.

You may feel round ligament pain when these ligaments stretch to hold up your (now much larger) uterus during pregnancy.

How do you stretch your round ligaments when pregnant?

During pregnancy, it may help to do gentle stretches of your pelvis and hips, but there isn’t one way to stretch your round ligament. If you experience round ligament pain, stop doing the movement and rest until it goes away. An abdominal binder can also help support your abdomen and improve round ligament pain.

When should I call my provider?

You should call your provider if you experience severe round ligament pain that lasts more than a couple of minutes, along with:

• Cramping.
• Fever or chills.
• Nausea or vomiting.
• Vaginal bleeding.
• Blood in your pee.
• Contractions.
• Pain when you pee.

A note from Cleveland Clinic

The round ligaments help support your uterus. During pregnancy, your uterus grows and puts these ligaments under tension. This tension can cause pain in your groin, hips and pelvic area. Talk to your healthcare provider about how to recognize round ligament pain during pregnancy. They can talk to you about ways to help ease any pain your round ligaments cause.