Should Sex Hurt After Having a Baby?

The quick answer to the question “Should Sex Hurt After Having a Baby?” is: no! Pain during sex is very common and is something we hear from our patients all the time. However, just because it is a common issue does not mean it’s normal. There is a lot of bad advice out there about painful sex, such as ”use more lubricant,” “just relax” or “have a glass of wine.” Not only is that type of advice unhelpful, but it also doesn’t address the root of the problem. You won’t get rid of pain during sex until you figure out what is causing it.

Since most people don’t openly discuss issues like this, it can be easy to feel as if it's all in your head. However, it affects more women than you might think. During pregnancy, postpartum, and  menopause, women who struggle with this issue tend to “wait it out,” thinking that it will resolve on its own. At Revitalize Physical Therapy, we are want to normalize the discussion about sex and help you find ways to actually enjoy it again! 

Issues with sex can be common in postpartum women. Check out our FREE POSTPARTUM GUIDE for other tips on recovering from pregnancy and delivery!

Why is Sex After Baby Painful?

There are many possible reasons you could be having pain during sex. Pelvic floor physical therapy can often be the solution! We’ll go through some of the typical culprits when it comes to painful sex and what you can expect from pelvic floor PT.  

1. Tight Muscles

Just like any other muscle in your body, the muscles in your pelvic floor can become too tight. The muscles can tighten in response to stress, trauma, childbirth, and changes in hormone levels. The tightness can be throughout all the muscles in the pelvic floor, possibly preventing you from tolerating penetration. The tightness can also be located in specific muscles, known as trigger points, that may produce pain only when provoked by penetration. High muscle tone can also affect arousal and the ability to orgasm due to the inability to relax and allow blood flow into the muscles. 

How We Can Help

To begin working to resolve muscle tightness, we use internal, manual techniques to release and relax the affected pelvic floor muscles. Patients typically can feel some improvement after only a few sessions! Relaxing these muscles can decrease pain during sex to allow penetration, but also increase arousal and ability to orgasm by increasing the blood flow into the surrounding muscles. Once the initial pain is improving, we can focus on how to prevent the muscles from tightening up again. We’ll also work to strengthen the muscles to help them function as best as possible!

2. Scar Tissue

Scar tissue in the pelvic floor develops as a result of improper healing of an incision or tear that is typically associated with episiotomy or tearing during childbirth. As the tear heals, the new connective tissue can be aligned poorly, causing bumps or raised areas that are highly sensitive to pressure, shearing, or friction. Scar tissue has lots of new nerve endings which produce a sharp, stabbing, or ripping pain when touched or when attempting intercourse. The scar tissue is usually at the opening to the vagina, but it can also go deeper into the vagina and pelvic floor muscles, depending on the path of the tear. As the scar tissue gets deeper, it can cause problems beyond just pain. Issues with strength and coordination of the pelvic floor muscles can also be a result of scar tissue.

How We Can Help

To decrease sensitivity and promote better alignment in the connective tissues, we use manual techniques directly over the scar tissue. This treatment can be uncomfortable for patients, but we always work within your tolerance and let you control the intensity. By applying direct pressure to the scar tissue, we are reorganizing and strengthening the tissues. This allows them to be able to tolerate pressure and friction like normal, healthy skin would. Once the scar tissue has improved from treatment, we can shift the focus to retraining the function of your pelvic floor. While it is better to address scar tissue earlier on, our treatment techniques can still provide relief if you’ve been dealing with scar tissue for a long time! 

postpartum recovery guide

3. Prolapse

Prolapse occurs when weak pelvic floor muscles or weak ligaments allow the pelvic organs to “drop” down within the pelvis. This can cause feelings of pressure or bulging in the pelvis, incontinence, and discomfort with sex. Prolapse can happen for many different reasons that we talk about in this video. Whatever the cause, prolapse can cause discomfort with sex, especially with penetration, because of the obstruction created by any of the affected organs within the vaginal canal. Prolapse can also cause patients to feel selfconscious during sex or feel like their prolapse is worsening.

How We Can Help

Treatment for prolapse can look different for everyone, but it has been shown that PT can help improve symptoms! Strengthening and working on coordination of your pelvic floor muscles can offer better support to the organs in your pelvis as well as decrease common symptoms. This can help with the perception of your prolapse and some of the anxieties that may also be impacting your sexual health. Other things like surgery or a pessary are options we can explore if pelvic floor PT isn’t getting the results you’re looking for. 

Recap: Should Sex Hurt After Baby?

Sex after baby should not hurt. But if it does, don’t be discouraged! You’re not alone, and there is help. If you still find yourself asking questions like, "Will this go away on its own?" or "Should sex hurt for this long?" let's talk! If sex has been painful or uncomfortable for you and you’re ready to fix this issue, contact us to schedule your free consultation.

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