Issue #2: Painful Sex Postpartum
What could be the reason you’re experiencing stinging after sex 6 months + after birthing vaginally and not breastfeeding? What can be done?
From Jaimie.
Hello Jaimie,
I'm four months 🤱 postpartum and I can relate! It can be hard getting your mojo back, like seriously who wants to pick sex over 🛌 sleep? Or 🥣 eating? Or 🚿 showering? Plus the anxiety of having anything going in there for the first time after childbirth 😬 my shoulders are always up near my 👂 ears in tension.
It is difficult to give a definitive answer, it's very individualised. Also the discomfort and pain may not necessarily be related to one particular type of birth. Pain can be related to muscles and nerves that were affected by 🤰 pregnancy and/or labour and/or birth and even women who have no tears following birth or women who had a caesarean section without labouring can have painful sex afterwards.
Research performed in Australia from 2015 found that 9 out 10 women experience pain the first time they have sex after childbirth and they discovered that almost a quarter of the women still reported painful sex 18 months later 😳 Multiple studies have found that women who gave birth via cesarean section or vaginally with vacuum extraction were about twice as likely to experience painful sex at 18 months postpartum compared to women who had spontaneous vaginal births. Women who reported painful sex at 6 months postpartum, one-third stated that painful sex persisted at 18 months postpartum.
Discomfort and pain can include a variety of sensations like stabbing, 🔥 burning, stinging, dry, sharp, ☄️ shooting pain, numbness, tingling and itching. Nothing there sounds pleasurable 😩
Let's go through some options that may be playing a part and then options to remedy.
Causes for Dyspareunia (painful sexual intercourse) after birth:
HEALING FROM BIRTH; is not linear and everyone will heal differently. Our pelvic floor/bowl support a lot of increasing pressure over 40 weeks and that increased support can put tension on muscles and muscles can strain and you may not feel effects of this strain until you engage in sex. Trauma to the tissue from grazing, tearing or episiotomy can cause pain and then the scar tissue from these tissues healing can cause discomfort or pain during sexual intercourse. Scar tissue even from a cesarean section wound can travel in the body and can cause painful sex further down the track.
HORMONES; when is it not hormones? God love them but geez sometimes 🙄 Estrogen is our vaginal lubricant and helps to keep our vaginas elastic and maintaining healthy and flexible vaginal tissue. And our estrogen levels make a dramatic drop 24 hours after birth and when you join that with the release of relaxin (another fantastic but 🙄 hormone) when 🤱 breastfeeding, it further drops estrogen levels which can make your vaginal tissues even thinner and drier.
EXHAUSTION; Mothering a 🤱 newborn can be hard and bloody 🥱 tiring! Nothing 😱 screams low libido like sleep 😴 deprivation. A low libido can result in sexual discomfort and pain.
EMOTIONAL DISTRESS; can also lower your libido. Adjusting to your postpartum body, perhaps there is a negative perception towards their body image, maybe birth trauma is involved and sex or penetration can bring back difficult memories, or stress and anxiety or PND (postnatal depression) are playing a role. To have enjoyable sexual intercourse you need sexual desire. Sexual desire = lubricant and aids in expanding your vagina.
BEFORE SEEKING ASSISTANCE; I suggest digging a little deeper and asking yourself these questions that may help bring clarity on what you are experiencing and may assistance in seeking out the right kind of help.
🤨 Does it hurt with insertion?
🤨 Is the pain superficial, deep, or on the sides or one particular side?
🤨 Does sex feel restrictive, for example stiff or dry?
🤨 Is it painful during or after sex or both?
🤨 Do you feel tense during intercourse?
🤨 Is there any heaviness in your pelvic floor/bowl?
🤨 After sex do you experience any urgency/leaking?
🤨 Have you been able to discuss with your partner what you are feeling?
REMEDIES to try. There are a few remedies you can try to ease the discomfort and pain during sex. First of all you can 🗣 talk to your partner, communicate how you are feeling and what you think may be playing a role in causing the pain. Lubrication, Lube and Lube! I'm not a huge fan of lube myself (slippery little suckers and mess makers) but I'd rather not have painful sex. Or you and your partner can pay special attention to lots of foreplay and increase your natural lubrication. You can also try different positions. Sounds easy and simple in theory but sometimes bloody hard in practice, and that is to 🫁 Breathe! Deep breathes in and on your out breath 🌬 let everything relax. Your jaw, your 👄 lips, your shoulders, your pelvic floor. And finally, a pelvic floor physical therapist. They are super bloody helpful in assessing and checking your pelvic floor and have a deep understanding in how your pelvic bowl all connects and may be required to discover why you may be experiencing painful sex.
One final note, REMEMBER to give yourself GRACE as you navigate intimacy following giving birth. Healing is not linear, your body, 🧠 mind and ✨ soul may have changed, there is no rush. Take it at your own pace and explore what feels good for you now, after experiencing birth.
For those women who get told at 6 weeks postpartum you are now ready to have sex again, there is no special marker, it's when it feels right for you. No one can tell you the time is right.
Thank you for bringing us a question that is so honest and open.
Love Kate 💚