Let’s talk about sex…

Here’s the thing- sex after having a baby is scary. It’s the kind of thing women whisper about with their best friends but NEVER mention to their pregnant or besties or out loud to their health care practitioners. Whether your birthed vaginally or by caesarian section- The idea of being intimate with your partner after birth tends to make most women run for the hills. Between constant feedings, having to adjust to living in a “new” body and sheer exhaustion – many women, understandably, just don’t feel like being intimate and when given the thumbs up at their 6-week postpartum check-up.

Today however, we are not going to address lack of desire after birth…… today we are going to talk about what happen when you DO have sex… and it hurts. Lack of interest in sex and not wanting to have sex because it hurts when you do are two very distinct things. While there are many factors to address women’s reduced desire after baby….. SEX WITH PAIN IS NOT NORMAL. I don’t care what kind of birth you had, what your friends are telling you or what your past experiences have been: It is not normal and you DON’T have to live with it!

So, today I am getting to the bottom of three of the most common causes of painful sex or Dyspareunia and what to do about them.

Here are the top reasons that sex can be painful postpartum:

Dryness-

If you are breast feeding- your hormone levels have a lot more in common with a menopausal woman than your pregnant and non-breastfeeding friends. In fact, we often refer to the period of breastfeeding as a “mini menopause”. The change in your estrogen levels often makes it more difficult for your vagina to lubricate when you are aroused.

FIX: Spend a little extra time with foreplay to encourage any natural lubrication. Also- add a little extra lubricant to your romp session!! Try to ensure that it does not contain any yucky ingredients (ie. Glycerol, formaldehyde etc..)

Scar pain-

If you had a vaginal delivery and you had any spontaneous tearing or an episiotomy, your body has healed by using scar tissue. Scar tissue is your body’s glue. Its job is to bring the two sides of the tissue together and make sure they STICK. Sometimes the scar can get very sensitive or tight- this can lead to pain when it is touched or stretched by anything penetrating the vagina.

FIX: a. Make sure you touch your scar. The idea of touching the scar is petrifying initially for many women. However, gentle touch really assists with desensitizing the scar and can work really quickly. Make sure you start gently!

Once you can tolerate it, make sure you massage the scar and ensure that it moves well- Some women rub the scar between their thumbs and forefingers. Your vaginal tissue expands and contracts- your scar should move like the rest of the tissue in the area!!

*** By the way- this is true for c-section scars too! Please make sure you touch your scars (once they are healed) and massage them regularly!!

Overactive, or tight, pelvic floor muscles-

If you are like most women, the most thought you have given your pelvic floor muscles is the two or three attempts you made at kegeling when you doctor or midwife instructed you to. Your pelvic floor muscles are a group of muscles which sit at the base of your pelvis and hold up all your organs, regulate when you pee and poo and whose optimal function is vital to a healthy sex life. Most women assume that after pregnancy their pelvic floor muscles are overstretched and weak and just need to be strengthen. However, very commonly, this extremely important group of muscles has been working so hard through your pregnancy and delivery that they are clenched- ALL DAY. EVERY DAY. In order for muscles to work well they must be able to contract AND relax. If your pelvic floor muscles cannot relax properly- penetration of any sort is often very uncomfortable. Also- it is not uncommon to see other signs of tightness like urinary leakage, constipation, back pain and hip pin.

FIX a. Stop what you are doing throughout the day and day a couple of slow, deep breaths. Not only does this allow you to unclench all your muscles, but the pelvic floor actually works together with your breathing muscle, your diaphragm. When you take a diaphragmatic breath in- your pelvic floor should naturally release. Try This: Start by Placing your hands on the sides of your ribs. Try taking a slow and gentle breath in and allow your ribs to gently expand into your hands. See if you can feel the air moving down and filling your trunk creating the sensation that your pelvis is filling with air. Try performing this breath 5 times in a row, a couple of times a day.

This fix is a little simpler and yet difficult to implement. You have to learn how to unclench your pelvic floor muscles. This is best done by visiting a pelvic floor physiotherapist who can teach you how to do it. But- the next time you go the bathroom- take note of the sensation of releasing your urine- that is a pelvic floor release. Try to replicate this release as you practice your breaths.

Remember- pain with sex is NOT normal and you do not have to live with it. If you have any questions or are unable to reduce your pain with these three tips, consult with a pelvic health physiotherapist.

I love to hear your comments and answer your questions!! Please let me know what you think below!

Xoxo

Chana