Painful Sex After Giving Birth – How Physical Therapy Can Help

Having painful sex after giving birth is common.

About 50+% of women have reported painful sex (dyspareunia) after giving birth.

Usually, it’s reported to occur at about 6 weeks after childbirth and can continue up to 6 months postpartum or longer.

Painful sex after birth can happen to any new mother, regardless if the birth was natural or via c-section.

Reasons why sex might hurt after childbirth

Sex after giving birth. It can be a time of mixed emotions.

Depending on what happened during the birth, you may have fear to pursue having sex with your partner again.

You could also experience pain with sex with either entering or penetration. This is called dyspareunia.

Some women describe the pain as burning, stinging, dry, and sharp.

At your 6 week visit with your OB or midwife, you will most likely be given permission to resume sexual intercourse. 

 In a 2018 study, almost 40% of women experienced painful sex 6 months postpartum.

Usually, it’s reported to occur at about 6 weeks after childbirth and can continue up to 6 months postpartum or longer.

Painful sex after birth can happen to any new mother, regardless of how you delivered naturally or via c-section.

There are a number of reasons why this may occur:

1). Healing from childbirth

There is quite a lot of pressure on your pelvic floor for the past 40 weeks.

This tension on the muscles can cause strain on these muscles which you may feel the first time you are intimate.

If you delivered naturally, you could have suffered tearing to the perineum or had to undergo an episiotomy.

Trauma to the tissue will most likely cause pain. Just like any tear or incision to your other muscles in your body, these tissues have to heal.

Everyone will heal differently. 

2). Lack of lubrication

You may also experience vaginal dryness for a number of reasons.

Your estrogen levels drop dramatically within 24 hours after giving birth.

Breastfeeding can also release relaxin that further makes your estrogen levels drop. 

3). Lack of interest and poor body image

This can greatly affect how you feel and may hinder intimacy. It may also create anxiety. Anxiety can further tighten your muscles.

A mental health practitioner can help you manage these feelings and provide you tools and resources. 

Painful sex treatments

There are a few things you can do prevent or minimize pain during sex in the postpartum period.

First of all, see a pelvic floor physical therapist for a postpartum assessment to address your concerns.

They can be very helpful in checking your pelvic floor in finding the driver to why you may be experiencing dyspareunia in the first place.

All of the physical therapists at FemFirstHealth in the NYC Tri-state Area are well versed in performing a postpartum assessment. 

Be sure to use ample lubricant…a lot! We recommend Slippery Stuff. You can also take part in quite a lot of foreplay or try different positions.

What is most important is to be honest and open with your partner and communicate your feelings.

Just like goals in parenthood, you need to express your goals as a couple now that you’re parents.

Make physical intimacy and emotional intimacy goals for your relationship.

Reference: O’Malley, D., Higgins, A., Begley, C. et al. Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study). BMC Pregnancy Childbirth 18, 196 (2018). https://doi.org/10.1186/s12884-018-1838-6