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Post-partum SEX…The Elephant in the room

physical therapy Jan 11, 2018

There is a myriad of things that happen to you and your body as you go through pregnancy. Besides physical changes, of which there are many, there are also hormonal and emotional changes. You may or may not have been sexually active during your pregnancy and you have been told you need to wait those 6 weeks before your doctor will give you the go ahead for most things, including sex.

Your 6 weeks have come… you had your appointment and you got the green light…but why can’t you have sex? Or why is it so uncomfortable or even painful? And why does no one talk about this?

So much has happened to your body!

  • First of all, there are the emotional and hormonal changes that you may be going through… You just may not have the urge and that is ok! If you are breastfeeding, that can cause decreases in estrogen which often leads to vaginal dryness.
  • You may be sleep deprived. The little darlings are adorable, but waking every couple of hours is tiring and leaves you fatigued without much energy to do anything, let alone have sex.
  • What the heck has happened to my body! Sometimes, many women have a hard time with the physical changes in their body. They may not feel “sexy”. Stuff doesn’t fit the same way. We may have gained a few pounds. We may now have stretch marks. These things are all normal and nothing to be ashamed of.
  • You may be hurting. There are quite a few reasons why you are in pain with sex. Let me put it into perspective for you…you just birthed a person!!!!That’s right. A living, breathing, squirming and wiggling person just exited your body. During that process muscles, ligaments and connective tissue can be stretched and depending on the type of birth you may have had and how stressful, there could be some serious trauma or injury to some of these tissues. You may have had an episiotomy or might have torn naturally and this can happen to varying degrees. In some cases there could also be significant muscle tightness. Yup! I said it! You have muscles “down there” and they are affected by trauma, just like your quads, hamstrings or any other muscle.

So, what can you do?

  • Use of lubricants can be helpful
  • Seek counseling if necessary. There are lots of resources available to assist. This may be helpful for those persons who are having issues communicating with or relating to their spouse.
  • Talk to your healthcare providers, especially if there are other issues such as post-partum depression that may be affecting you.
  • Seek out a pelvic health physical therapist. Did you know that a pelvic health physical therapist can assess you both externally and internally to address issues with pain, trigger points, muscle weakness as well as providing strategies for improving your overall function post birth whether it may your normal daily activities, posture, returning to sport, dealing with incontinence, sexual issues etc.

This doesn’t have to be a troubling time. Know that you are not alone and there are resources and clinicians available to assist you with whatever you may be dealing with post birth. In many states, you can go directly to your women’s health physical therapist through a process called direct access where they act as primary providers of healthcare without a referral first from an MD, OB or GYN.


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