Written by: Cailyn McDonnell, PT, DPT

Many moms will experience pain or discomfort with sexual activity or intercourse after birth. This is a very common and often distressing occurrence that can happen due to a number of different factors. Some of the biggest reasons why we experience painful sexual activity postpartum include: 

• The stress of having to take care of a new baby 
• Anxiety/depression/baby-blues postpartum 
• Hormonal shifts and decreased libido 
• Vaginal dryness/decreased lubrication due to decreased estrogen in the vulvovaginal tissues 
• Perineal trauma/scar tissue that is still healing 
• Increased pelvic floor muscle tension 

Many healthcare providers will recommend waiting until at least 6 weeks postpartum to return to sexual activity and/or penetrative intercourse. This is due to the fact that the body is still healing, recovering and also learning how to care for a newborn. Some folks will return to some level of intimacy at 6 weeks but many will often wait even longer due to the reasons above. So how and when will you know that you are ready? Some things to notice and look out for include:

• Perineal tears have healed 
• Vaginal bleeding has stopped
• Pain in pelvic area is no longer there 
• Swelling has gone away 
• Libido has returned/you want to reconnect with yourself or your partner. 

When you are ready to re-engage in intimacy here are some helpful tips to get started:

• Grab a water-soluble or silicone based lubricant. Some of our favorites include: Good Clean Love, Uberlube, and SlipperyStuff. Often-times vaginal dryness can linger due to decreased estrogen in the vulvovaginal tissues postpartum. Water-based lubricants are no mess, no stain and gentle on tissues-but they dry out fast. Silicone based lubricants may leave a stain on the sheets or clothing, but they are also gentle on tissues and last longer. Avoid using silicone based lubricants on silicone toys- it may degrade the material over time. Ingredients to avoid in lubricants include fragrances, glycerin, and parabens. 
• Stretch/warm up before the big event! Sex after birth can be intimidating but we can warm up and stretch before just like we would before a marathon or athletic event. Some helpful stretches include gentle yoga poses that open the perineal area and hips/pelvis. Some of our favorites include: happy baby pose, reclined butterfly pose, cat/cow, wide knee child’s pose, and deep slow diaphragmatic breathing exercises. 
• Explore your own body before you engage in partnered sex. You know your body better than anyone else, and it just went through a major change. Take some time for yourself to rediscover pleasure and what feels good. This can be in the form of masturbation or even gentle self touch on new areas of the body that may feel good such as chest, legs or abdomen. 

If you find that you are still experiencing pain with sexual activity postpartum, reach out to a pelvic floor physical therapist. They can help identify what is causing the pain and together you will come up with a plan of care in order to reduce or even eliminate the pain! Our team is ready to help you today, give us a call to learn more about what physical therapy can look like for you.