Five Tips for Returning to Sex Postpartum

Five Tips for Returning to Sex Postpartum

You went to your 6 week check-up and you’ve been cleared to have sex. Now what? You may have questions on how to return to sex. Let’s go over five tips for returning to sex after birth.

1. Try Not to Put Pressure on Yourself

Just because you are cleared to have sex does not mean you have to have sex. You are ready when you are ready. Maybe its not even on your mind yet. There are many reasons you may want to delay sex and that is okay.

2. Start by Yourself
Start with self pleasure. This is a great way to reignite self exploration and pleasure postpartum. Have your partner take the baby and have some uninterrupted time to yourself. Use a dildo, vibrator, or hand and start external with touch. A dildo or vibrator could be used to help mimic the stretch of a penis. If you have any nervousness around how penetration will feel, I recommend inserting a vibrator or dildo into the vagina on your own first. This gives you some time to explore how it feels.

HELP! I inserted my vibrator and it was painful. What do I do?

There is more than one reason why penetration could be painful postpartum. I want to be clear that whatever the reason, there is help and it is not your new normal. Make sure to communicate this with your birth professional so they could guide you into getting appropriate help.

Tight and Tender Pelvic Floor Muscles

The muscles of the pelvic floor can get tight and tender after a vaginal or cesarean birth. Pregnancy itself is challenging for the pelvic floor muscles. They are sustaining increased load for the duration of your pregnancy with the weight of the uterus and baby. Vaginal birth stretches the pelvic floor muscles 250% of their resting length (1). Think about how your body might feel if you challenged any other muscle in this way. The pelvic floor muscles and surrounding tissue are still recovering up to 4-6 months postpartum (2). It is okay to give your muscles some time to heal.

Scar Tissue

Scar tissue from perineal tears and episiotomies could cause a sensation of tightness, pain, and irritation which could limit the pleasure of penetration or touch to the vulvar area (3). If you are introducing penetration as soon as your are cleared by your provider, it is important to realize the body and your scar are still maturing and remodeling for optimal healing.

Dryness

84% of women report difficulty with vaginal moisture postpartum which can be influenced by breastfeeding, hormonal contraception, and vaginal delivery (4). Use a lubricant to help reduce friction and irritation of your vaginal tissue.

Need some guidance? Read my blog post "The Myth of Wet and Ready: A Saga That Has Lasted Too Long" for tips on choosing a lubricant that works for you.

REMINDER: If you are having pain during any part of sex, a pelvic floor physical therapist could help you with tools to help lengthen and relax the pelvic floor muscles and mobilize and desensitize scar tissue so that penetration is no longer painful and you have smoother postpartum recovery. 

3. Warm-up
Arousal is the body’s response to the desire to have sex which brings blood flow to the clitoris and changes the resting muscle tone of the vagina. Take time to warm-up 10-15 minutes prior to penetrative sex to help your vagina get ready. Arousal doubles the length of the vaginal canal creating more space, increases vaginal moisture, and increases blood flow to clitoris for increased pleasure (5). You could add a vibrator or dildo into your warm-up routine. Consider using a vibrator or dildo internally with your partner if you have some tightness of your pelvic floor and need some controlled time to allow the muscles and surrounding tissue to relax before penetration with a penis.

4. Use Lubricant
An oil-based or silicone based lubricant could be helpful for vaginal dryness postpartum. Remember to not use a silicone lubricant with any silicone based toys and not use oil based lubricant with latex condoms.
Need some guidance? Read my blog post "The Myth of Wet and Ready: A Saga That Has Lasted Too Long"  for tips on choosing a lubricant that works for you.

5. Communicate With Your Partner
Go slow and let your partner know what feels good just like you would do prior to having a baby. There may be some fear and nerves the first time you return to being intimate for both you and your partner. Take time to understand each others needs. Consider starting with external play, mutual masturbation, or toy play prior to penetration if that’s more desirable.

Happy Exploring!


DISCLAIMER: THIS ARTICLE DOES NOT PROVIDE MEDICAL ADVICE

The information, including but not limited to, text, graphics, images and other material contained on this article are for informational purposes only. No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.


All content copyright Ariel Zablocki



Sources: 
1. Selman R, Early K, Battles B, Seidenburg M, Wendel E, Westerlund S. Maximizing Recovery in the Postpartum Period: A Timeline for Rehabilitation from Pregnancy through Return to Sport. Int J Sports Phys Ther. 2022 Oct 1;17(6):1170-1183. doi: 10.26603/001c.37863. PMID: 36237644; PMCID: PMC9528725.
2. Svabík K, Shek K, Dietz H. How much does the levator hiatus have to stretch during childbirth? BJOG. 2009;116(12):1657-1662. doi:10.1111/j.1471 0528.2009.02321.x
3. Claire Cardaillac, Bérénice Delga, Thibault Thubert, Jean-Jacques Labat, Amélie Levesque, Norbert Winer, Thibault Riant, Stéphane Ploteau. Description and classification of postpartum chronic pain: A multicentric prospective study, Journal of Gynecology Obstetrics and Human Reproduction, 2020 49 (9), 2020: 2468-7847, https://doi.org/10.1016/j.jogoh.2020.101769.
4. Mbarki, W., Bettaieb, H., Frikha, M., Abidi, I., Halouani, S., Boufarguine, R., Oueslati, H., & Mbarki, C. (2022). Prevalence of and risk factors associated with vaginal lubrication issues in women at 6 months postpartum. The Journal of Sexual Medicine, 19(Supplement_2). https://doi.org/10.1016/j.jsxm.2022.03.529
5. Biology of Sexual Function in Females. Boston University School of Sexual Medicine . (2002). Retrieved March 25, 2023, from https://www.bumc.bu.edu/sexualmedicine/physicianinformation/female-genital-anatomy/

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