You were cleared at your six-week postpartum visit. Your doctor said everything was healing normally, so why does sex still hurt?
This is a question we hear often from new mothers.
Being “cleared” at six weeks means your provider has determined that your postpartum recovery is progressing appropriately from a medical standpoint. It does not necessarily mean that intercourse will immediately feel comfortable, or that your pelvic floor muscles, vaginal tissues, and any scar tissue are fully recovered.
There are several reasons sex can continue to hurt months after giving birth.
Scar tissue can remain sensitive
If you had a vaginal tear, episiotomy, or other perineal injury during delivery, the area may have healed on the surface while the underlying scar tissue is still sensitive or less flexible.
Scar tissue can feel tight, tender, pulling, or painful with penetration. Even a small area of sensitivity can cause discomfort during sex.
Breastfeeding can affect vaginal tissue
If you are breastfeeding, your estrogen levels remain lower than they were before pregnancy. Lower estrogen can contribute to vaginal dryness and changes in the vaginal tissue, which may make penetration more uncomfortable.
This is one reason some women are surprised that sex still feels different months after delivery, even when everything appears to have healed normally.
Your pelvic floor muscles may be protecting you
Your pelvic floor muscles went through a tremendous amount during pregnancy and birth. If you experienced tearing, stitches, pain, or fear of pain during recovery, your pelvic floor muscles may respond by tightening.
Sometimes that tension continues even after the original injury has healed.
The result can be a cycle: penetration hurts, your muscles tighten to protect the area, and the increased muscle tension makes penetration even more uncomfortable the next time.
Pain is not something you simply have to push through
Postpartum pain with sex is common, but that does not mean you have to accept it as your new normal.
A pelvic floor physical therapist can evaluate the muscles, scar tissue, pelvic floor coordination, and other factors that may be contributing to your symptoms. Treatment is individualized and may include addressing muscle tension, scar mobility, tissue sensitivity, and how the pelvic floor responds to penetration.
If sex continues to hurt months after giving birth, you are not failing at postpartum recovery. Your body may simply need more time, support, or treatment than a six-week checkup can provide.
You do not have to wait until the pain becomes severe to ask for help.
Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.