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Why Does Sex Hurt After Giving Birth?

Pelvic Floor Doctor

Medically Reviewed By Dr. Amanda Olson, DPT, PRPC

Women who give birth both vaginally and via cesarean section (c-section) are often alarmed to experience pain with sex after having a baby. It is understandable that injuries to the skin and pelvic floor muscles due to vaginal delivery may produce pain with sex in the first few months after delivery. However, many women who undergo c-section experience pain, too. Read on to find out why sex can be painful after birth, as well as what to do about it.

Vaginal Birth

Changes to the Pelvic Floor During Pregnancy Can Result in Pain During Sex

The nature of being pregnant involves supporting the extra weight of the baby, placenta, and often the extra fluid throughout the body during pregnancy. Your pelvic floor muscles have the job of supporting this new and growing weight, which can lead to a strain on them.

Sometimes, the pelvic floor muscles can develop tender points like you feel in your neck or back when you lift something heavy or performed a strenuous task with your arms. These tender or "trigger points" can be addresses using what are called pelvic massage tools.

The strain inflicted on the pelvic floor muscles often heals within eight to 12 weeks of delivery. If your pain persists longer than that, be sure to discuss it with your physician. Pelvic physical therapy is a specialized form of physical therapy that can help address muscular pelvic pain. 

Scarring Around the Vaginal Opening Can Result in Pain During Sex

The tearing during vaginal delivery and repair by stitching can result in the formation of scar tissue around the opening of the vagina. Scar tissue is stiff and much less flexible than the original skin, fascia, and muscle tissue.

This lack of flexibility can result in the narrowing of the soft tissue around the entrance of the vagina and sometimes in the vaginal canal itself. 

Woman Giving Birth

However, the good news is that it is possible to soften the scar tissue to improve the flexibility of the vaginal opening and vagina after the scar has fully healed around the 12-week mark. Using dilators, also referred to as vaginal trainers, are effective in improving the flexibility and reducing the pain in the vagina after birth. 

Hormonal Changes Can Lead to Vaginal Dryness After Giving Birth

There are hormonal changes after giving birth and with breastfeeding, your estrogen levels decline. This leads to less circulation of blood flow to the walls of the vagina and the soft tissue around it. With this comes vaginal dryness, which can make penetration extremely painful.

However, using generous amounts of water-based personal lubricant such as Velvet Rose is helpful. Using two tablespoons to lubricate the outside and inside of the vagina will cause far less friction during sex.

Velvet Rose

You can use a suspension medicine dropper, such as those found in infant medications to apply the lubricant directly into the vaginal opening. This technique helps to push the lubricant deeper into the vagina.

There are still other reasons why you may be experience pain during sex after giving birth which is why it's always recommended to consult a physician if pain persists. 

Amanda Thumbnail

By Dr. Amanda Olson, DPT, PRPC