Painful Sex After Baby? Here’s Why!
“I tried having sex for the first time after I had my baby and it hurt so bad!”
As a pelvic floor physical therapist this is something that I actually hear A LOT from my patients, regardless of whether they had a vaginal delivery or cesarean birth. If you are experiencing painful sex in postpartum, know that is common but not normal, AND you are not alone! So often women that I work with feel that there is something wrong with them, feel ashamed, or don’t know where to turn for help so they simply deal with the pain.
Painful sex does not have to be a consequence of childbirth, there is help!
Before we dive into the help that is available, let’s dive into four reasons why sex can be painful after having a baby. Painful sex can be multifactorial, so often times there is a combination of factors at play.
1) Hormonal Changes: when you give birth to your baby, your hormones can fluctuate significantly, especially if you are breastfeeding. Estrogen is a hormone that is decreased for a short time after birth and can stay decreased while breastfeeding. Decreased estrogen affects that vulvar tissues, often causing thinning and dryness.
2) Pelvic Floor Muscle Tension: your pelvic floor muscles go through a lot when you give birth. After birth, these muscles may be tight, tender, and guarded. If you had any perineal trauma or tearing, these muscles may be especially tender. Having a c-section does not “protect” the pelvic floor either! In fact, there is evidence to support that women who had a c-section may have an increased chance of painful sex. This is because your pelvic floor muscles are so closely linked and intertwined with your deep core muscles, diaphragm, and connective tissue around the abdomen and pelvis.
3) Perineal Trauma: tearing to the vaginal and vulvar tissues with childbirth can cause pain in this region. There can also be residual scar tissue, which may be tender or irritated. Many women who have perineal tearing do heal and recover very well, but there is a sub-set of women who have a more difficult time with healing. If you had a grade 3 or 4 perineal tear (a tear extending to the tissues of the anus), there is evidence to show that you may be more likely to have painful sex.
4) Life Changes: having a baby is just downright hard! Lack of sleep, changes in roles, new relationship challenges, returning to work, learning how to take care of a little human, is a lot to manage! Sexual libido and desire may look different during this time than at other points in your life. Be kind and gentle with yourself and your needs.
What kind of help is out there?
Talk to your medical provider: set up a visit with your OBGYN or primary care provider. They can make sure to rule out any potential infections or other medical issues that could be contributing to pain. They may also recommend of topical medication to help improve the estrogen at your vulvar tissues.
See a Pelvic Floor PT!: All the lubricant and sexual arousal in the world won’t fix tight/tender pelvic floor muscles or painful scars. A pelvic floor physical therapist can help to identify what muscles and tissues are causing the problem and help you create a plan to heal and resolve pain. They will take time to learn about your pregnancy and birth history, current symptoms, and your goals. From there they will go through a full-body, comprehensive exam to determine the best plan for you in helping you return to happy and healthy sex life!
Lubrication: Don’t be afraid to use a little help from lube! Helping the natural lubrication process with a lubricant process can provide a night and day difference. Apply lubrication prior to and during sexual activity. It is recommended to use an all-natural water based lubricant.
Educate your partner on what is helpful: Including your partner in on this process can be so helpful. Have them read this blog post and/or attend a doctors or pelvic PT visit, so that you partner can learn more about what you are experiencing and be supportive in your journey. We can even teach you and your partner techniques and strategies you can try at home that can be helpful!
Wondering if Pelvic PT is right for you after having your baby? Talk to us, we’d love to answer any questions and help you navigate your options. Click “Contact Us” to learn more!
