Sexual Healing: Many women experience a painful return to intercourse or other sexual activity after having a baby. Pain during intercourse is not normal and should not be viewed as a normal outcome of pregnancy or childbirth. The causes or issues associated with pain during sexual activity vary dramatically but many fall in to the topics below.
Lubrication: A common cause of post-partum sexual discomfort or pain can be a lack of vaginal lubrication. The body’s natural lubrication is lessened during the post-partum period, due to hormone levels, and may persist until the woman stops breastfeeding. A good solution is to use plenty of lubrication to replace what is naturally missing during this phase. Foreplay, even extended foreplay, is also a good means to allow the body time to heighten sexual response prior to attempting penetration. It’s important to communicate with your partner to ensure a comfortable return to sexual intercourse.
Dyspareunia (said “dis-puh-roo-ne-ya”) is painful sexual intercourse for women and can be referred to as a type of Sexual Dysfunction. For many women, this is a very difficult topic to discuss. Some women wonder if the pain is all in their heads or feel concern that they may be doing something wrong in bed. Many women, more than 1 in 5, experience phases of recurring painful intercourse at some point in their lives and the post-partum period is one of the most common times.
Pain can be felt either in the genital area or internally, deep inside the pelvis, or both. It can be extreme enough to cause pain and discomfort simply from sitting or wearing pants or it can be felt only with insertion of a tampon or penis into the vagina. Women’s descriptions of pain vary significantly from burning, sharp pain, pain or discomfort similar to menstrual cramps, a feeling that something inside is being “bumped,” or a generally achy feeling down there.
Vaginismus (said “vaj-in-iss-mus”) is a spasm of the muscles around the vagina. In some women, the pain of penetration is so significant that penetration becomes impossible. Certain conditions, infections, or illnesses can cause painful intercourse. In any case where you experience significant pain during intercourse, you should seek the care of your doctor as well as a physical therapy evaluation with a PT skilled in pelvic floor therapist who can help aid in developing a unique, personalized solution to your symptoms.
Healing: We know that pregnancy and delivery put strain on the muscles and other structures in and around the pelvis. Tightness in the muscles of the pelvic floor, either from normal post-partum healing or tightening prior to intercourse due to anxiety about how it may feel, can cause pain with penetration initially or with deeper penetration. We also know that our minds and bodies work together, especially for women. In some cases, even if the cause of pain (episiotomy scar, c-section scar, site of a childbirth vaginal tear, etc.) goes away, if you have learned to expect the pain it may lead to further problems. You may be tense during sex or may be unable to become aroused.
Some women find that their sex drive seems low or even gone during the post-partum period and beyond. Demands of a newborn baby, changes due to hormones, extra body weight, body image issues, and lack of sleep may all contribute to a low or lower-than-usual interest in sex. Remember to be patient with yourself, talk with your partner honestly, and try to enjoy touching and cuddling while you learn your way back to your ideal sexual self and experience.
Talking: Like many post-partum complaints, pain with sexual intercourse is common but it is not normal and should not be simply ignored or lived with. Many women are too embarrassed to seek treatment or don’t know where to turn. Don’t stay quiet and live with it! Talk with your doctor, seek the care of a physician or physical therapist who can help, and you may find that treatment improves your overall sexual experience, your body image, and your personal health.