It's been several weeks since the birth. Between breastfeeding, lack of sleep and fatigue, you and your partner have found a moment of intimacy. But… Surprise! Pain! As if giving birth hadn't been painful enough…
Why do some women experience pain (called dyspareunia) during sex after giving birth (vaginal delivery)? Here are some explanations.
First, perineal scarring is the most common reason for pain during postpartum sex. It often happens during childbirth that there are natural tears in the vagina or vulva. The same is true for women who have had an episiotomy. In these cases, scar tissue forms and creates pain.
Good news, because it is possible to reduce pain by massaging it.
Some people believe that there is muscle relaxation in the pelvic floor postpartum; but instead there may be muscle tension. This has the effectreduce the vaginal opening and create pain during intercourse. It is generally sufficient to reduce muscle tension using manual techniques and perform muscle rehabilitation of the pelvic floor in order to regain adequate control.
In another vein, it is important to understand that postpartum, there is a hormonal imbalance. The drop in estrogen and progesterone may persist for varying periods of time depending on the woman. This can also be maintained by prolonged breastfeeding.
Low estrogen and progesterone levels can lead to decreased vaginal lubrication, decreased libido, and hypersensitivity of the vaginal entrance and walls. This is why the use of a personal lubricant becomes a must during this period. Unfortunately, this is not always enough…
It is often necessary to consult in perineal rehabilitation to desensitize the vaginal area, reduce muscle tension and regain muscle control of the pelvic floor.
Finally, the pain could also be explained by organ descent. It is important to understand that organ descent does not necessarily cause pain during intercourse!
However, the descent most likely to cause pain is the descent of the uterus, as this causes the cervix to be lower. The cervix is a verysensitive, then the back and forth during penetration can create deeper pain. It is necessary, among other things, to reduce the factors increasing the descent and to ensure a good strengthening of the muscles of the pelvic floor.
Remember that it is important to discuss this, whether with your doctor and/or your physiotherapist in perineal and pelvic rehabilitation. Do not hesitate to consult, because it is not normal to have persistent pain during sexual relations after childbirth.
Douanka Gendreau, pht, M. Sc. Physiotherapist in perineal and pelvic rehabilitation Clinique Pelvi-Sant é