It seems like such a natural thing, right? Isn’t it supposed to be fun?
I hear it so often from women who take the leap and come to Body Works. It makes me hurt in the pit of my stomach when I hear them speak of hiding their faces during sex, not wanting to admit to their partner how much it hurts. So why does it hurt so much?!
That is a very long answer but in a nutshell we can point to several key factors.
First, sex is multifactorial, meaning there are a lot of factors that come into making it a fun time. There are factors that can make you less motivated or resistant to having sex after baby from things like sleep deprivation, emotional toll of a newborn, lactation-induced dryness, anxiety, depression, and just generally feeling “touched out”. But there are also many reasons from our muscles, joints, and nerves that can cause pain with sex, and that’s what pelvic floor physical therapists are excited to help with!
Pregnancy brings with it a fabulous bundle of joy. But it also ushers in a lot of tissue trauma, meaning overstretching or tearing to the muscles, skin, and/or fascia. There may have been tearing and sutures that will create some scar tissue. Tightness can result as the tissues are trying to repair themselves. A very rapid delivery or a very long labor can both do a number on those sensitive pelvic floor tissues. Pelvic floor muscles have to stretch an awful lot during vaginal delivery; in fact, the pelvic floor muscles stretch FOUR times their original length during delivery. As these deeper muscles heal, they can become very tender and tight as well.
So you might be thinking, what a minute…I had a Csection birth, why do I have pain with intercourse after pregnancy?
The tummy is actually a complex system. We rely on strength from our tummy muscles, pelvic floor, diaphragm and and our low back muscles to do all of our daily activities and more. As pregnancy progresses, these tummy muscles get really stretched out. And when a muscle gets really stretched out, it causes it to not work as well. After pregnancy, the abdominal muscles are overstretched and weak which can cause the pelvic floor muscles to have to “pick up the slack” so to speak. In other words, the pelvis is needing some stability and the stomach muscles aren’t able to do the job, so the pelvic floor muscles compensate and work overtime and this leads to tension. Additionally, if you had a Csection birth, there is now a scar in your deep core muscles, so mobility in this scar is important to help the deep core function at its best.
And honestly, once sex with a partner doesn’t go well and is painful, are we really relaxed the next time around? Pain teaches us that we should avoid something, but how can we reconcile that in our relationship?
So if this sounds like what you’re experiencing, what do you do? There is a lot of misinformation out there about pain with sex, and we are here to help give you clear, evidence-based information and treatment. It takes courage to step up and start talking about pain with sexual activity. It can be a little uncomfortable, but we promise, we are here to help. We’ve heard it all! We can help address the muscles, joints, and nerves that need to be “re-wired”, and we can help with scar tissue mobility and balancing the core muscles. We are big fans of educating your partner and helping guide you to the right therapist who can help you (and your partner) with the emotional and mental components that can come along with this.
A pelvic floor physical therapist can help you unravel the cause and, better yet, get you on a path to healing. This is supposed to be fun, not painful!
