Sexual Dysfunction

Sex after babies and Sexual Dysfunction

Sex may be the last thing on your mind as you and your partner adjust to life with a newborn, but for some couples, sex and intimacy can be an important way to reconnect. Whatever your unique situation, we can all agree that sex after childbirth is a subject that is deeply personal and dependent on individual circumstances.

So, when can I have sex again?

The best time to have sex again is probably when you actually feel like it! The decision is very much yours, but some questions to ask yourself and talk with your partner about…

  • Am I emotionally ready? How do I feel about it?
  • Am I allowing myself enough time to heal?- if you have had perineal stitches or a c-section wound, you want to ensure these are well healed with no active bleeding (most GPs suggest waiting for 4-6 -weeks as a general rule).
  • We know that 6- weeks is the average amount of time it takes the uterus to return to its normal size, the cervix to close and any incisions to heal. This suggests that for some women this will take longer, so waiting for your 6-week GP check-up may be a good time to get the go-ahead.
  • Have I considered contraception?

Sexual dysfunction

For many new mums, after childbirth, sex can feel a little different or women commonly experience short-term issues with pain, vaginal dryness, orgasm or libido. Studies suggest that for many women these issues gradually resolve over time. One such study reported that 85.7% of women experienced pain the first time they had sex after childbirth. After 3 months this figure reduced to 44.7% and 22.6% at 18 months post-partum. This highlights that 20% of women may still have some pain with sex a year and a half post-natally which is not something that should be ‘put up with’. We would advise you to inform your GP or health care provider if ongoing pain or other sexual difficulties are proving an issue for you and your partner.

If difficulties persist, a diagnosis of female sexual dysfunction (FSD) may be made by your healthcare provider. The clinical types of FSD according to the American Psychiatry Association are as follows:

  • Reduced sexual desire. This involves a lack of sexual interest and desire to be intimate.
  • Sexual arousal disorder. You may still want to have sex but you have difficulty maintaining arousal or are unable to become aroused during sex.
  • Orgasmic disorder. You maybe be unable to orgasm or find it extremely difficult.
  • Sexual pain disorder. You have pain associated with sexual stimulation or vaginal contact- this term includes other diagnoses such as dyspareunia, vaginismus and vulvodynia.

 

Why is this happening to me?

We ladies are complex creatures, and many factors can influence our sexual experience. We know that our sexual function is a complex balance between our physical, hormonal, neurological, vascular, psychological and emotional health. If there is an issue with any of these factors, or the interaction between them, it can lead to sexual difficulties which can be distressing and a strain on your relationship with your partner.

Potential causes of sexual difficulties postnatally:

  • Pain with sex initially can result from trauma to tissues during the delivery process
  • Perineal tears, episiotomy scars or c-section wounds may still be healing or creating tension in nearby tissues. The pelvic floor muscles can become shortened and tight which can lead to pain with penetration.
  • Hormonal changes can lead to vaginal dryness and changes to the vaginal tissues. Dry tissues can lead to irritation and even bleeding, during sex
  • Following the delivery of your baby, there are many emotional and social factors at play. You may have feelings surrounding your changing body form and shape. You may be exhausted, and sleep deprived and caring for a newborn can be stressful at times, to say the least.
  • There are various other potential causes for FSD aside from common post-natal changes that include:
    • Infection
    • Skin conditions
    • Prolapse
    • Hormonal changes (pre and post-menopausal),
    • Nerve conditions
    • Fear
    • Endometriosis
    • Cancer (and cancer treatments)

It is important that you fully discuss your symptoms with your GP to determine the underlying cause of your symptoms. That way you can be treated the most effectively.

What treatment is available?

FSD is best treated with a team approach, with involvement from the medical team alongside a pelvic health physiotherapist and sex therapist where appropriate.

First-line treatment may include lifestyle modification, sexual health counselling and prescription medication to discuss with your GP.

After ruling out infection, skin conditions, or other serious pathologies a Mummy MOT practitioner can assess and support you with an individual management plan that may include:

  • Education and teaching pain management strategies.
  • Exercises and breathing techniques to alleviate anxiety (with support from other clinicians where required)
  • Teaching effective pelvic floor exercises including relaxation and lengthening techniques where needed.
  • Manual therapy (which may include internal pelvic floor release)
  • Teaching breathing techniques which help to engage your core and pelvic floor.
  • Meditation techniques
  • Advice regarding lubricants or devices where required

Remember:

If you are having difficulty with any of the symptoms we have talked about, please reach out. Sexual dysfunction is not something to put up with and the Mummy MOT team is ready to listen and support you to meet your goals.

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