Sat. Oct 1st, 2022
Painful sexual intercourse after childbirth: what is it due to and when

Painful sexual intercourse after childbirth: what is it due to and when is it necessary to consult

Pregnancy does not have to mean a break in the couple’s sexual relations, in fact, if there is no risk, having sex during pregnancy has many benefits. However, after having a baby and after having passed the immediate postpartum period, many couples find it difficult to resume their relationships, and there are even women who report the appearance of problems or discomfort during intercourse .

We have talked about it with Sara Cañamero , midwife, sexologist and director of Maternatal. Sara wants to make it clear from the beginning that “sex should never hurt, and if it hurts you have to look for the cause of the problem” . Therefore, what causes can these be and what is the treatment for pain during sexual intercourse? We clarify all doubts!

Main sexual problems after childbirth

As Sara Cañamero explains, studies estimate that postpartum sexuality is not only affected and altered, but that more than 80% of women have some type of sexual dysfunction , the main ones being:

  • Dyspareunia or coitalgia : refers to the pain or discomfort that occurs during intercourse
  • lack of sexual desire
  • Anorgasmia secondary to childbirth : it is the inability or difficulty to reach orgasm once sexual intercourse is resumed after giving birth.
“In consultation we see above all sexual dysfunctions after childbirth related to women’s low sexual desire and pain on penetration,” summarizes the expert.

What are the causes of sexual problems after childbirth?

The midwife and expert in sexology ensures that pain or discomfort during penetration after childbirth can be due to multiple factors:

  • Lack of lubrication : Poor vaginal lubrication can not only make intercourse difficult, but can make intercourse especially uncomfortable or painful.

Sara explains that during the postpartum period (especially if the woman is breastfeeding), there is a drop in estrogen (similar to what happens during menopause) that ends up affecting vaginal lubrication. The good news is that it can be fixed very easily by using lubricants .

  • Fear of penetration : according to Sara, after an episiotomy or a tear it is very common for women to fear having sex again. In doing so, many contract and tense, and contracting the pelvic floor muscles is when the pain appears .
  • Untreated scars : the expert insists on the importance of treating scars after childbirth, whether it is the scar of a cesarean section or an episiotomy.

“Untreated scars generate adhesions in the tissue, and these adhesions cause discomfort, pain and many other inconveniences. It is necessary that after delivery, a specialist assesses the state of these scars and treats them if necessary” , he advises .

  • Pelvic floor hypertonus : during pregnancy and childbirth the pelvic floor undergoes very important changes , as it is subjected to great weight and great effort. This can cause contractures in the muscles that end up causing pain during penetration.
  • Low sexual desire : Discomfort during intercourse can also be due to a woman’s low sexual desire.

“Whether due to her new and recently acquired role as a mother, due to fatigue, the stress of the first weeks of motherhood, due to lack of time or due to the emotional cascade that accompanies postpartum, women can see their sexual desire altered. As there is no desire, the woman does not become aroused during intercourse and, therefore, the lubrication will be less” – explains the sexologist.

  • Low self-esteem : the midwife assures that this is one of the main reasons why difficulties usually arise when it comes to resuming sexual relations after childbirth.

“During the postpartum period, many women do not recognize their body and that means that they do not look sexually desirable to their partners either. This low concept of themselves ends up making them inhibit themselves when it comes to having sex and, therefore, their desire and arousal. come down” .

Does the type of delivery influence the pain during sexual intercourse?

Although it is common to think that vaginal delivery is a risk factor over cesarean delivery when it comes to pain during intercourse, Sara Cañamero clarifies that this is not always the case.

“Studies indicate that problems and pain in sexual relations after childbirth occur regardless of the type of delivery that the woman has”

“In this sense, women who have given birth by caesarean section may present penetration pain with the same frequency as those who have delivered vaginally. However, what does influence is the fact that the vaginal delivery was traumatic , with instruments or suture complications. In those cases, the chances of painful intercourse are higher” .

“My sexual relations are painful: when and to whom should I consult?”

Starting from the basis that sex should never hurt and it is a mistake to normalize it , Sara recommends consulting from the first moment the woman notices discomfort, otherwise the problem could become chronic.

However, once this premise is clear, doubts may arise about which specialist to consult : a midwife? a gynaecologist? a sexologist?… The expert explains that in these cases the approach must be multidisciplinary , because, as we have already seen, there are several aspects that can influence.

“When there are difficulties or pain in sexual relations after childbirth, the problem must be approached from different spheres: sexologists, midwives, and physios specialized in pelvic floor will approach the subject in different ways , depending on the origin of the problem”

“It is important for the woman to find a specialist with whom she feels comfortable talking and explaining what is happening to her. Depending on the origin of the problem, the professional will work only with the woman -either treating adhesions, helping to relax the muscles pelvic, worked scars…- or with the two members of the couple”.

“It is also essential that women and their partners understand that sex should not only be limited to intercourse. To reduce it to that is to greatly simplify human sexuality, and more specifically female sexuality.”

” Pain during sexual intercourse has a solution when the problem is addressed early and with the appropriate specialist(s). And while the source of the problem is being worked on, if intercourse hurts or bothers, I encourage couples to find other ways to maintain relationships that help women feel comfortable and relaxed during this vulnerable stage such as postpartum “ .