Sex After Birth

Sex after Baby

Feedings?  Diaper changes? Utter exhaustion?  Sex after a baby could be the furthest thought on your mind.  Here is what you need to know…

How soon can I have sex?

Generally, we recommend some time for your body to heal whether you had a vaginal or cesarean delivery.  I would advise waiting until your physician or midwife tells you that it would be okay. This is usually around four to six weeks after your delivery.  The postpartum bleeding needs to subside and tears and lacerations need to heal. 

However, there is an important emotional aspect that needs to be considered. Are you ready?  Every woman is different. Some women are ready within a few weeks and others might be ready within a few months.  Stress, lack of sleep, and fear are three factors that can also play into your desire to feel ready. 

Feeling disconnected with your partner can determine how ready you feel.  Realizing that physical intimacy can help with this is one factor that you should take into consideration.

Will it be painful?

It is possible that sex might be uncomfortable and painful initially.  It is advisable to take it very slow with lots of foreplay.  Lubricants are recommended since vaginal dryness is common when breastfeeding.  Communication with your partner is vital.  Mindfulness on the moment with your partner can help when you notice your thoughts moving to the baby and life stressors. 

What type of Postpartum changes occur?

If you do experience painful sex after your delivery, it is most likely temporary.  For most women, it improves between three and six months after your baby is born.  

Estrogen levels decrease after delivery and breastfeeding also keeps estrogen levels low which can cause vaginal dryness, decreased libido and pain during sex.  Lubricants can help with this. 

Oftentimes decreased muscle tone in the vagina can occur that can influence arousal because of the reduced friction during intercourse.  This is usually temporary.

If pain with sex is persistent, feel free to contact us for an appointment. There are various treatment modalities that we can use to treat this. 

Sexual Pain Problems?

Do you have pain with intercourse? Is this affecting your relationship with your partner? Sexual pain problems can be caused by an array of conditions and can be very disruptive to your quality of life.

Pain with intercourse can include: endometriosis, infections, problems with involuntary tightening of the vaginal muscles (vaginismus), vulvar and vaginal skin conditions such as vulvodynia or vestibulodynia amongst many other types of disorders.

The causes depend on the type of condition and are usually a combination of physical, chemical, and psychological factors.  This is why it is important to take an integrative and holistic approach to find out the causes of your condition. 

An examination for sexual pain should include a 360 degree evaluation including a medical and psychosocial assessment, a validated sexual pain questionnaire, a physical examination, a vulvoscopy (taking a close look at the vulva and vagina with a special lens), sensation tests involving a Q-tip to identify the tender areas, and a hormonal evaluation via a blood test if indicated. 

An integrated treatment plan is then discussed and can include the following: compounded or conventional hormonal/nonhormonal treatments, pelvic floor physical therapy, neurobiofeedback, sex therapy, acupuncture, heart rate variability training, lubricants, moisturizers, meditation/mindfulness training, laser treatments, and herbs where appropriate.  It should be noted that surgery is normally reserved as the last option. 

I will be discussing specific conditions and their possible treatments in future blog posts.