We Have to Talk About Sexual Dysfunction After Childbirth

Childbirth is no easy feat, and many women suffer sexual issues after childbirth, including dyspareunia, loss of vaginal lubrication, pain upon orgasm, post-coital bleeding, itching and burning.

Dyspereunia is the clinical term for painful intercourse. This can increase during breastfeeding, which is known to cause lower levels of natural vaginal lubrication due to a decrease in estrogen. Dyspereunia is also associated with the intensity of perineal damage. The perineum is the skin between the vaginal opening and the anal opening, which stretches during childbirth and sometimes tears.

Generally, the type of delivery (vaginal or cesarean section) doesn't affect the immediate severity of dyspareunia, though in the longer term, vaginal delivery may have less of a lasting effect. Some assume that because C-section delivery prevents damage to the perineum, it will decrease the chance of sexual dysfunction postpartum, but that is not the case.

Vaginal deliveries may result in a more significant decrease in natural lubrication than C-section deliveries. However, both types of delivery often result in vaginal dryness due to fluctuating hormone levels post-birth.

In my own experience, buying hypoallergenic lubricants or lubricants designed to fit in with natural body chemicals from a pharmacy can help with reducing pain, particularly when it is caused by vaginal dryness. However, it's always important to check with your doctor, as they might find a yeast or bacterial infection is causing this pain.

Physical damage can affect sexual function

The type of damage differs by method of delivery. Vaginal delivery may cause pudendal nerve damage and vaginal prolapse due to weakened pelvic muscles, episiotomy and lacerations.

The pudendal nerve is part of the pudendal plexus network of nerves, located near the tailbone and reaching to the rectal and genital areas. Damage to this nerve can affect the functioning of the bladder, rectum and genitals, causing incontinence and sexual dysfunction. Vaginal prolapse occurs due to weakened pelvic muscles and when the rectum, uterus or bladder push on the vagina, sometimes so extremely the vagina protrudes out from the body.

An episiotomy, which is a medical incision in the perineum, affects sexual function much longer and more intensely than tears or other damage caused by either method of delivery, but this is still most likely to heal within three weeks. It was originally thought that an episiotomy would heal better than a natural tear, but now episiotomies are only used when necessary to ease delivery, for example, if the baby is stuck in a difficult position for natural vaginal delivery.

There is an additional impact on sexual function (physical ability, not necessarily desire) when both fecal and urinary incontinence are issues after childbirth.

Talk about it

Women who suffer from sexual dysfunction after giving birth should consult their healthcare professional, as many difficulties can be brought to an end sooner rather than later with professional consultation. It's especially important to talk to your doctor if you experience pain before, during or just after sex, bleeding after sex or sensations such as itching and burning in or around your vagina.

With fluctuating hormones, exhaustion and major physical changes, you may need mental health support as well, and that is completely normal. Talk to a therapist. Connect with other new moms to discuss similar experiences. Attending sexual counseling with a trained medical professional both before and after childbirth can also help you navigate the various issues that can arise.

Sexual dysfunction after childbirth is very common, and you're not alone.