man and woman under a duvet together

If you think about it, the process of carrying your baby to term and delivering your little one is quite something! Your body goes through an immense amount of changes during the three trimesters, but it’s what happens during childbirth and in the 4th trimester that could be the culprits for painful sex. Despite the fact that 50-60% of women can experience pain during sex after childbirth, only 15% of women seek help for this! Sex should never be painful! There are many reasons why you might experience painful sex post partum, so here’s some of the most common culprits:

Loss of natural lubrication

The most common reason for painful sex at any time is that a woman is not sufficiently aroused, and thus not producing enough natural lubrication. After giving birth, your lowered estrogen levels will wreak havoc on this normal part of female sexuality. Breastfeeding can, of course, exacerbate this! I recommend using a silicone-based lubricant to help things feel more comfortable – you could also use a water-based lubricant, but this doesn’t tend to last as long. The only oil-based product that is safe to use is coconut oil, as all other oils or lotions can cause vaginal infection (but all oil products cause microtears in condoms so avoid these if you’re using!). Wetter is always better!

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Pelvic floor changes and scarring

Your pelvic floor has been through 9 months of having a baby resting on them and then having gone through the process of labour and birth, so it’s inevitable that this muscle group will be affected and thus impact sex as well. The muscles may be weaker as a result of this and they could overcompensate and tighten leading to discomfort or painful sex. If you needed to have an episiotomy, tore during natural vaginal delivery, or had a caesarean, it’s important not to rush into things until you’re healed. This can be anything from 6 to 12 weeks post partum. Any of these experiences can also contribute to trauma to your pelvic floor and be a possible cause for pain during sexual intercourse.

Anxiety and worry

Anxiety is the most common cause of sexual pain that I work with, and following giving birth, I often see a woman’s anxiety levels are quite high, specifically in relation to having sex again. Unfortunately, the more we worry about experiencing discomfort and pain during sex, the more likely it is that your body will be tense and you’ll experience discomfort and pain during sex! When our brain is filled with worried thoughts, it’s going to be tough to relax and let go during sex, both physically and emotionally.

If you’re regularly experiencing pain during sex post partum, seek out help from a pelvic floor physiotherapist. There is as an incredible network of pelvic physios in South Africa, and you can see who to consult with closest to you via www.mysexualhealth.co.za
Catriona is an accredited clinical sexologist, psychotherapist, sexuality researcher & speaker. She is an expert in the field of sexual behaviour, intimacy, relationships and mental well-being, with a particular interest in helping people create or reestablish sexual intimacy and empowering women to embrace their sexuality. She has delivered her expertise across media, business and private platforms and is a globally recognised voice in the field of sex, pleasure and relationships. She runs a global practice online, consulting with clients from around the world, but has a practice in Johannesburg, South Africa and London, United Kingdom.