Barriers to Restoring Sexual Function After Childbirth

Why Sexual Function After Childbirth Can Be a Challenge

Disclaimer: This blog post is based on research performed on cis-gendered women

Many women are told at their 6 week postpartum follow-up, that they are cleared for sexual intercourse, however, most women do not return to sexual intercourse at this time frame, for several reasons1,2. If this is you, you are not alone, and you are actually in the vast majority. During this unique time in a woman’s life, she is experiencing physical, emotional, and relational changes that all influence a woman’s sexuality. Physically, many women experience pain with sex, lack of desire, and decreased lubrication².

One of the biggest causes found to contribute to these symptoms was hormonal changes related to whether a woman is breastfeeding during the postpartum period or not. While breastfeeding can offer a host of benefits, for mom and baby, it can be a cause of pain with sex because of the decreased sex hormones impacting the tissue of the vagina and vulva2,3, leading to a condition called vulvodynia. For more information about this condition, and if this sounds like you, check out this blog post to learn more.

Other physical factors leading to sexual dysfunction include whether there was perineal tearing during delivery or episiotomy performed2. Some good news: while many women also experience difficulty reaching orgasm earlier postpartum, compared to pre-pregnancy, women actually showed improvements in ability to orgasm at the 6 and 12 month timeframes postpartum in a survey of 1400 women2. Another beacon of hope from the same study; while women had higher levels of pain with sex at 6 months postpartum compared to pre-pregnancy, by 12 months the amount of women experiencing pain with sex was lower than pre-pregnancy levels.

Of equal importance, on top of these physical changes impacting a woman’s sexual health, many women experience emotional changes including: depression, the responsibility of assuming new roles, fears surrounding motherhood, and self-image distortion1,2. Not to mention, the extreme fatigue and exhaustion that accompany sleepless nights caring for a new baby, and lack of time to carve out intimate time with their partner.  

If you are experiencing pelvic pain with sex, don’t wait until you are done breastfeeding–there are interventions with pelvic floor physical therapy that can help give you relief during this unique period.!

At Femina Physical Therapy, all of our physical therapists have specialized training to address the musculoskeletal components of your pain and will work with your other healthcare providers in a collaborative manner to maximize symptom-relief and improve your quality of life. Reach out to our team to get started restoring your own sexual function after childbirth.

Read more blog posts in this series: How Orgasm Improves Postpartum Pelvic Floor Function and Coping Mechanisms for Sexuality Changes Postpartum. 

Resources: 

1. Delgado-Pérez E, Rodríguez-Costa I, Vergara-Pérez F, Blanco-Morales M, Torres-Lacomba M. Recovering Sexuality after Childbirth. What Strategies Do Women Adopt? A Qualitative Study. Int J Environ Res Public Health. 2022;19(2):950. Published 2022 Jan 15. doi:10.3390/ijerph19020950 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8775547
2. O'Malley D, Higgins A, Begley C, Daly D, Smith V. 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. 2018;18(1):196. Published 2018 May 31. doi:10.1186/s12884-018-1838-6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984394/
3. Perelmuter S, Burns R, Shearer K, et al. Genitourinary syndrome of lactation: a new perspective on postpartum and lactation-related genitourinary symptoms. Sex Med Rev. 2024;12(3):279-287. doi:10.1093/sxmrev/qeae034 https://pubmed.ncbi.nlm.nih.gov/38757214/