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Whether you’re pregnant and feeling new pressure in your pelvis or postpartum and dealing with a changed body, it’s not unusual to experience pain or aversion during intimacy. In fact, a lot of people report painful sex (dyspareunia) in the first few months after childbirth. But pain is never something you just have to “push through.” It deserves understanding, attention, and care.
Pregnancy and birth fundamentally reshape your body. That shift affects how your tissues stretch, how your nerves respond, and how your mind relates to touch.
Here’s how pregnancy and birth can alter your sexual experience:
- Hormonal shifts change lubrication and arousal. Oestrogen levels drop sharply after birth and it often leads to vaginal dryness and thinning of the vaginal walls, which can cause friction and pain during sex.
- Tissue trauma takes time to heal. Tears, episiotomies, or C-section scars can create lingering soreness, scar sensitivity, or even nerve pain in the surrounding areas.
- Your pelvic floor is recovering. Vaginal birth stretches the pelvic floor muscles significantly. If they’re weak, tight, or scarred, they can spasm during penetration, making sex painful or impossible.
- Internal organs shift. During pregnancy and immediately after birth, your uterus and other pelvic organs are repositioned. This can make deep penetration feel different or painful, especially in certain positions.
- Breasts may be engorged or sensitive. For many breastfeeding mothers, arousal feels different or even uncomfortable. Let-down reflex can trigger milk leaks during sex, which may cause anxiety or embarrassment.
Why Pain During Sex Matters Beyond the Physical
Sexual pain can begin in the body, but it often lingers in the mind, where memory, identity, and fear quietly shape your experience of touch.- Fear of pain increases tension. Anticipating discomfort often leads to clenching, which makes pain worse, a self-perpetuating loop.
- Low self-image post-birth can affect desire. If you feel stretched, stitched, or sagging, you may not feel confident or desirable. This affects how relaxed and open you feel during intimacy.
- Trauma from birth can leave emotional imprints. Especially if you had a difficult labour, emergency surgery, or felt dismissed by care providers, your body may carry tension or fear without conscious awareness.
- Relationship dynamics shift. New roles as parent, caretaker, and recovering patient can make you feel more like a “body that functions” than one that feels or enjoys. That change can deeply affect sexual willingness or satisfaction.
What Causes Painful Sex During and After Pregnancy?
Here are the most common reasons, medically and emotionally, why intimacy may become painful:- Vaginal dryness and thinning: Common during breastfeeding due to low oestrogen.
- Tears, episiotomies, or scar tissue: Can cause soreness, nerve hypersensitivity, or tightness.
- Pelvic floor dysfunction: Weak or overactive muscles may lead to spasms or pain during penetration.
- C-section recovery pain: Abdominal pressure during sex may hurt if the scar area is still tender.
- Fatigue and resentment: When you're all touched out from baby care, your body may shut down emotionally or physically.
How Is It Diagnosed and What Can Help?
Pain during sex (dyspareunia) is typically diagnosed based on your symptoms and history. There’s no single test, and diagnosis often requires a compassionate conversation.You don’t have to suffer in silence. Here’s what can help:
- Pelvic physiotherapy – Trained specialists can help release scar tension, retrain muscles, and improve comfort
- Lubricants and vaginal moisturisers – Especially useful if breastfeeding-induced dryness is a problem. Choose water-based or hyaluronic acid options
- Oestrogen creams (if recommended) – Very low-dose vaginal oestrogen may be prescribed to treat vaginal atrophy or severe dryness
- Massage and gentle reintroduction – Some couples find relief through gradual, non-penetrative touch before reattempting sex
- Time and patience – Sometimes, the most healing thing is waiting longer than six weeks. There’s no “right” timeline
Reclaiming Intimacy: Emotional and Practical Support
Pain changes how we relate to intimacy, not just how we experience it. Here’s what can help emotionally:- Name the experience without shame. Painful sex isn’t a failure. It’s a common postpartum reality.
- Talk with your partner. Let them know what you’re feeling, physically and emotionally. This builds intimacy even without intercourse.
- Seek therapy or counselling. Especially if you’ve experienced birth trauma, body image struggles, or identity confusion postpartum.
- Normalise your pace. Whether you’re ready at 6 weeks or 6 months, your body gets to set the timeline. You don’t need to perform closeness. You deserve to feel safe in it.
FAQs on What Causes Pain During Pregnancy and Postpartum Sex?
- How long does the pain after childbirth last during sex?
Most people feel discomfort for up to 3–6 months. But if pain persists, seek help. Pelvic floor therapy can offer real relief. - I had a C-section, but why does sex still hurt?
Pain can stem from scar adhesions, pelvic floor tension, or hormonal dryness. It’s not just about vaginal trauma. - How do I know if I have pelvic floor dysfunction?
Symptoms include pain during penetration, urine leaks, constipation, or heaviness in the pelvis. A pelvic physiotherapist can help diagnose and treat it.