It’s no secret – for many women, the experience of having sex after having a baby can be quite different than it was before baby.  It is typically recommended that women wait 6 weeks postpartum before having sex in order to minimize the risk of infection, but many women aren’t aware of some of the symptoms they may experience during  sex in the postpartum period even after those 6 weeks (especially from a physical standpoint – the emotional and hormonal side, well that’s a whole other blog post).

Vaginal Dryness

A decrease in estrogen while breastfeeding in the postpartum period can cause vaginal dryness. Estrogen creams prescribed by your doctor or non-hormonal lubricants such as coconut oil can be used to help with vaginal dryness. When choosing a lubricant, be sure to avoid brands that have drying agents or harsh chemicals.

Pain during intercourse

Painful intercourse (dyspareunia) can occur for a couple different reasons:

  • Pelvic Floor Dysfunction:  Muscles in the pelvic and/or hip region can become tight as a result of pregnancy or delivery, and can cause intercourse to be painful.  Pelvic health physiotherapy can help lengthen the pelvic floor muscles to alleviate pain caused my pelvic floor muscle tightness and strength imbalances.
  • Perineal tearing, episiotomies, and the use of forceps or vacuum during labour and delivery can result in injury to the pelvic floor muscles and tissues. Scar tissue that develops during the healing process can become hypersensitive and cause pain during intercourse. In addition, scar tissue is often shorter than normal tissue and can restrict normal movement of the pelvic floor and/or abdomen (in the case of a c-section). This tissue restriction can result in pelvic floor tightness, which can make intercourse painful, as previously described. Pelvic floor physiotherapy can help mobilize scar tissue to decrease this type of pain.
  • Hormonal changes that occur in the postpartum period can also cause intercourse to be painful. The area around the urethra and vagina openings, called the vestibule, is hormone-dependent and can become hypersensitive with the decrease in estrogen that occurs during the postpartum period. Pain at the vestibule can result in pain at initial penetration during intercourse, pain with inserting a tampon, and/or pain with vaginal exams.

Pelvic organ prolapse

A prolapse occurs when a pelvic organ, such as the bladder or rectum protrudes into or out of the vaginal canal. Women with a prolapse can experience discomfort and/or friction with intercourse or inserting a tampon. Prolapse education and pelvic floor muscle strengthening are crucial to the management/treatment of prolapse symptoms.

Amanda Jones, MSc (PT), MSc (Med Sci), BSc (Biomed), is a graduate from the Masters of Physiotherapy Program at McMaster University. She provides both orthopaedic and pelvic health services at Eramosa Physiotherapy Associates in Orangeville.