For many new mums, the idea of returning to sexual intimacy after childbirth can bring up a mix of emotions—excitement, anxiety, and sometimes, concern. One common issue that often arises is painful sex, a challenge that many women experience but few talk about openly. Understanding why this happens and how to address it can help make the transition back to intimacy smoother and more comfortable.
Why Painful Sex Happens Postpartum
Postpartum, your body is adjusting to a lot of changes, and it’s completely normal to experience discomfort during sex. Marnie Poiner, a women’s health physiotherapist and mum, explains that hormonal changes, particularly the decrease in estrogen, can make the skin less flexible and more prone to pain during penetration. "Besides not usually having much desire for sex after having your bub, it often doesn't feel great as the skin isn't as flexible due to the hormonal changes after birth," she says.
In addition to hormonal changes, the physical trauma of childbirth, whether vaginal or cesarean, can lead to discomfort. The tissues of the pelvic floor are affected by pregnancy and birth, which can contribute to pain during sex. It's important to remember that this is a common experience, and there are ways to manage it.
Steps to Manage Painful Sex
If you’re experiencing painful sex postpartum, the first step is to give yourself time. Marnie recommends waiting until your post-birth bleeding (lochia) has stopped for at least seven days before attempting penetrative sex. This helps minimize the risk of infection and gives your body time to heal.
When you feel ready, it's crucial to go slow and prioritize comfort. Marnie suggests starting with non-penetrative activities and using high-quality lubricants to reduce friction. "Oil-based or silicone-based lubricants create the most frictionless penetration," she notes, but advises against using lubricants from general stores like supermarkets.
It's also essential to focus on adequate arousal before attempting penetration. “It takes about 15 or so minutes for females to experience the full genital arousal response, which helps blood flow into the tissues, relax the muscles, and increase hydration,” Marnie explains. Ensuring you’re fully aroused can help make sex more comfortable and enjoyable.
When to Seek Help
If painful sex persists, it’s important to seek help from a qualified professional, such as a women’s health physiotherapist. Marnie emphasises that pain isn’t something you have to live with, and a pelvic physio can provide personalised advice and treatment to address the issue.
In some cases, pain may be related to overactive pelvic floor muscles, which can contribute to discomfort during sex. A physio can assess whether this is the case and recommend exercises or treatments to help.
Communication Is Key
Finally, open communication with your partner is crucial. Let them know how you’re feeling and what you need to feel comfortable and relaxed. Marnie suggests framing the conversation in a way that doesn’t blame your partner but instead focuses on your experiences. For example, saying, “My skin feels really stingy with penetration at the moment,” rather than, “It really hurts when you…”
Navigating postpartum sexual health can be challenging, but with the right support and information, it’s possible to overcome these difficulties and enjoy a fulfilling sex life again. Remember, you’re not alone—many women face similar challenges, and help is available.
Marnie Poiner is a women's health physiotherapist, sexologist, new mum, and all-around pelvic health expert. If you're based in Brisbane, you can visit Marnie at The Healthy Peach Physio at the Grange.
Read more about Marnie's experience and motherhood journey here.
