Oh, let me count the
ways. Really. I’m counting the reasons sex hurts after having a baby and I
can think of seven of them:
1. The extra
stitch. If you had a vaginal birth and tore naturally or the doctor
cut the perineum (the space between the vagina and the anus) and you
needed stitches and you have a really, really old-fashioned
doctor…it’s very possible you got “the Husband Stitch”. This is an extra,
unnecessary stitch at the perineum that is supposed to make your vaginal
opening smaller. Sometimes women ask for this, most of the time they
don’t. The doctors take it upon themselves to do this because they think
they are doing you a favor – for your sex life. How thoughtful, right?
Some women don’t even know they got this, all they know is that their
vagina feels smaller and they have “no idea why”. This can cause pain
with sex. It’s not that the stitch doesn’t heal correctly, it’s that your
vagina is smaller. This opens up a whole can of worms that this post isn’t
going into.
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2. No
extra stitches. Just the ones you needed. So, if you needed
stitches and had an ethical physician, then you got exactly
what you needed. These stitches will heal well, but sometimes they can leave
you with scar tissue at the perineum. This can be really problematic with
sex because scar tissue makes everything tighter and more sensitive. It can
make your muscles in your vagina way too tense when they are supposed to be
relaxing.
3. Natural
tearing. Same thing as #2. Even with natural tearing you are going to
have some scar tissue. If you don’t work through this scar tissue and massage
it and knead it (yes, like bread) then it can create painful sex.
4.
Breastfeeding and dryness and low libido. Breastfeeding can lower
your natural hormone levels inside and outside the vagina making sex dry
and lowering your sex drive. This is a snowball problem. No, not that kind
of snowball problem (you are nasty!). But, if you don’t have sex
drive, your vagina will not get wet. When your vagina doesn’t get wet
enough, there is friction and this feels like sandpaper and tearing. You must,
must, must use some sort of lubricant. I think that the most gentle
lubricants for painful sex are coconut oil and olive oil or something
water-based like Slippery Stuff. I really hate KY and Astroglide. They do
great marketing, but they’re really not made for the sensitive vagina.
5. Having
sex and worrying about the baby waking or being in the room. So,
the really cool thing about the pelvic floor (the support muscles in the pelvis
that keep up all your organs and span from all around your vagina and
clitoris to all around your anus and from one hip to the other,
basically) is that they respond to what we’re thinking. They are mind readers.
Your pelvic floor is a mind reader. That is amazing, right?
When you are scared, nervous, anxious or uncomfortable, your pelvic floor
muscles will automatically respond and tense up. This makes your vagina and
your anus smaller – in that moment. It’s a really primitive response.
It’s your body’s old-fashioned way of trying to protect your reproductive parts
so that you will survive and continue to make more humans. It’s fascinating! I
really stress that if you have pain with sex, you really have to have sex when
the timing is right for your mind. When your brain is more relaxed, your vagina
is more relaxed.
6. C-section. Just
like the stitch scenario, c-sections leave scars. If you don’t work this scar,
the scar tissue will grown down into the layers beneath it and really create
problems. This can cause bladder problems, bowel problems and…painful sex. No
one really enforces how important it is to work that scar. And if you’ve
had repeat c-sections – holy moly cannoli! – work the scar! You might not
have problems now, but if you don’t work that scar, you will have
problems later.
7.
Attempted vaginal delivery and a c-section. You’re fucked.
No, not really, I just thought that was funny. But, it’s not really funny
because both your pelvic floor and abdomen have been through Hell and back. You
might have perineal tearing and a c-section scar. You’ve got a lot of reasons
why sex could hurt, so work the scars in both places to minimize and eliminate
the problem.
So, if you’ve found
yourself with any of the Seven Unsexy Sins, there is good help available.
Pelvic floor physical therapy is a specialty of physical therapy that is
completely devoted to pelvic issues – whether it’s pain or incontinence or
constipation or something quite scandalous. In many countries (the United
States not included) pelvic floor physical therapy is a
standard aspect of care after delivering a child.
Pelvic floor
physical therapy is intimate and it’s invasive, but it’s really not as
uncomfortable as people expect it to be. A pelvic floor physical therapist will
do an exam on your pelvic floor muscles, determine what your exact reason for
painful sex is, then they will teach you things that you can do at home and
they will do “hands on” work inside the vagina and outside the vagina. If
you have an unsexy sin, checking out a Pelvic floor physical
therapist is worth a shot. You deserve to be sexy again.
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