Bringing a child into the world is an incredible experience, but it can also bring about significant changes in a woman's body. One common issue that many women experience after pregnancy is painful sex, also known as dyspareunia.
Although distressing for new mothers, solutions are available once the underlying cause is determined by your OB/GYN.
Read on, to understand the main causes of painful sex after pregnancy and learn the most effective steps you can take toward enjoying pain-free sexual intimacy again.
Why Is Sex Painful After Pregnancy?
Sex can be painful after pregnancy due to hormonal changes that cause vaginal dryness and the physical trauma of childbirth, which may result in tears or episiotomy scars. Additionally, the uterus and pelvic muscles need time to heal, making intercourse uncomfortable.
How Long to Wait to Have Sex After Childbirth?
Considering the postpartum healing that the female body requires after childbirth, whether your baby was delivered vaginally or via C-section, most OB/GYNs recommend waiting 4-6 weeks before resuming sexual activity.
Postpartum Sex Pain Causes
When postpartum sex is painful after this recovery time, it is generally due to hormonal changes, vaginal tears, episiotomies, scar tissue, or pelvic floor dysfunction. Each of these is outlined in greater detail below.
It is common knowledge that the female body undergoes significant hormonal changes during pregnancy. After childbirth, hormone levels continue to fluctuate while the body returns to its pre-pregnancy state, and estrogen, in particular, drops rapidly.
Because estrogen helps to keep the vaginal walls healthy and lubricated, a rapid drop in estrogen typically results in the vaginal walls becoming thinner, drier, and less elastic. This ultimately culminates in a condition known as vaginal dryness or atrophy.
Women experiencing vaginal dryness commonly feel friction, discomfort, and pain during sex as the vaginal walls become more susceptible to microabrasions, tearing, and bleeding. Breastfeeding can also impact postpartum sex due to the added decrease in estrogen that typically happens during lactation.
Therefore, new moms who are breastfeeding might experience vaginal dryness for longer, or more intensely, than those who don’t.
Vaginal Tears or Episiotomies
During vaginal childbirth, the area between the vagina and anus which is also known as the perineum, can tear when overstretched during delivery. In some cases, an episiotomy or surgical incision is performed to widen the vaginal opening.
Perineal tears and episiotomy incisions require time to heal after childbirth and engaging in sexual activity before they are completely healed can cause pain and discomfort.
When women experience vaginal tears or undergo an episiotomy or C-section while giving birth, the incision site can develop scar tissue as it heals. Scar tissue in itself can be sensitive and it can also affect the surrounding nerves and tissues, resulting in pain during sex after pregnancy.
Pelvic Floor Dysfunction
Depending on a woman’s body and delivery experience, pregnancy and childbirth can weaken, tense, or tighten the pelvic floor muscles. When these supportive muscles are not sufficiently strengthened or relaxed after childbirth, women can experience various types of pelvic floor dysfunction including painful sex, as well as pelvic organ prolapse, incontinence, and/or constipation.
Emotions & Confidence
Negative thoughts about body image and anxiety can also contribute to painful sex after pregnancy. The months after childbirth can be emotionally challenging given the fatigue, stress, and worry that most new mothers navigate and this type of emotion can directly affect their libido.
Many women also struggle with their body image after pregnancy, which often translates into an absence of sexual desire and can result in painful sex due to a lack of arousal.
How to Make Sex Less Painful After Giving Birth
Even though the severity and duration of painful sex after pregnancy can vary from woman to woman depending on their birth experience, treatment is invariably successful and new mothers do return to enjoyable and pain-free sex.
When seeking the correct treatment for your condition it is important to first consult with your healthcare practitioner or OB/GYN to determine what is causing your pain. Once the underlying cause is understood, an effective treatment plan can be put in place.
The following are the most effective options to treat painful sex after pregnancy:
If your healthcare practitioner determines that vaginal dryness is the primary cause of your pain during sex after pregnancy, using a water-based lubricant will help to reduce friction and discomfort during intercourse.
Because they are typically fragrance-free and non-irritating for sensitive vaginal skin, water-based lubricants are considered healthier and more effective than oil-based or silicone-based lubricants.
Ensuring that your genitals are well lubricated before penetration will alleviate friction and discomfort, as well as protect the vaginal walls from tearing and microabrasions.
Pelvic Floor Rehabilitation
Although many believe that pelvic floor physical therapy like kegel exercises alone will fix all pelvic floor issues, this is not the case. Kegel exercises, especially with the help of silicone kegel weights, will help to strengthen weak pelvic floor muscles after pregnancy. However, if the pelvic floor muscles are tight after pregnancy, silicone dilators are more effective to relax and stretch the tense muscles.
When pain during sex is felt deep within the pelvis, pelvic wands are recommended to massage and relax deep pelvic trigger points.
To understand whether your discomfort during sex is caused by weak or tight pelvic floor muscles, book an appointment with a pelvic health physical therapist, who will also instruct you on how to correctly use dilators, kegel weights, or pelvic wands in the privacy of your own home.
In addition to helping women heal after pregnancy, using kegel weights, vaginal dilators, or pelvic wands for your condition will also improve the intensity of your future orgasms.
Scar Tissue Massage
When new mothers have experienced vaginal tears during childbirth, or undergone an episiotomy or C-section, scar tissue massage significantly helps in alleviating pain during sex. Even though scar tissue will never disappear completely, the correct massage techniques will smooth out any lumps and mobilize the surrounding tissue so it doesn’t cause indefinite pain.
For instance, using a silicone pelvic wand to gently massage perineal scar tissue after childbirth will not only help to improve blood flow, but it will also help to break down adhesions, release tension, and promote healing. Although designed for self-use, it is important to receive initial instruction on the technique of scar tissue massage from a physical therapist or women’s health practitioner before practicing at home.
Welcoming a baby can be wonderful, but accepting the postpartum body changes can be difficult for some new mothers. While it's normal to lack the time for practicing self-love and self-care in the first few weeks after your baby is born, just a few minutes here and there has been proven to increase postpartum self-esteem.
Try to focus on speaking positively about yourself and your body in the first few months, and believe the compliments from your partner and others when they tell you that you look well. Take time to journal and recognize that it’s OK to feel your feelings, and speak openly with friends who have been through childbirth before.
It’s also a good idea to stay away from the weighing scales for a while and wear clothes that fit comfortably rather than trying to get back into pre-pregnancy clothes too early. In time, you and your body will bounce back. Be patient.
That said, if you feel as if your body image is lowering your sexual desire and resulting in painful sex due to a lack of arousal, make an appointment to speak with a therapist about it. Life is long and to be enjoyed. Don’t lower your sexual happiness due to body shaming yourself or being too embarrassed to talk about it.
Painful sex after pregnancy is an issue experienced by many women, and although it can be upsetting and uncomfortable, effective treatments are available. Medical tools like Kegel weights, pelvic wands, and vaginal dilators designed by women, for women, not only help to heal pelvic muscles, incisions, and scars experienced during delivery, they also help to regain sexual confidence and improve orgasms.
If you are looking to treat pain or discomfort during sex after pregnancy, a consultation with your preferred healthcare professional will enable you to understand the specific cause of your pain and help you to put an effective treatment plan in place.
Very Well Family - Painful Sex Postpartum: Why It Happens and How to Deal - https://www.verywellfamily.com/painful-sex-postpartum-why-it-happens-and-how-to-deal-5184693
Parents - 3 Common Reasons for Postpartum Sex Pain And What to Do About Them - https://www.parents.com/parenting/relationships/sex-and-marriage-after-baby/common-reasons-for-postpartum-sex-pain-and-what-to-do-about-them/
Healthline - Vaginal Scarring Is One of the Top Reasons Vulva Owners Find Penetration Painful - https://www.healthline.com/health/healthy-sex/vaginal-scarring
Wellness In Mind - Sex after childbirth: The Good, the Bad, and the Ugly - https://wellnessinmind.ca/blog/sex-after-childbirth-the-good-the-bad-and-the-ugly/