Sex After Baby… When you don’t get that feeling you may need sexual healing

So you have just delivered your little bundle of joy…

You are probably getting back into the swing of things, starting to get into a routine, and feeling a bit more like your old prenatal self. At around 6-8 weeks most women have their postpartum checkup from their obstetrician and are “cleared” to resume sexual activity. Partners anxiously await the “greenlight” for sex, but are most women ready to jump back into the sack / saddle so soon? Many are not. Regardless of type of delivery, many new moms do not feel physically or emotionally ready. The pressure on new mothers to “bounce back” after childbirth from magazines, social media, or partners with high libidos, can leave many couples with unrealistic expectations for what life in the bedroom will be soon after baby. Maybe women should be counseled that is more normal to ease, rather than jump back into an active and joyful sex life.  Understanding the biological changes that occur in a woman’s body, the effect these changes have on sexual function, and what can be done to address these concerns can help women and couples have a happy and healthy sex life after childbirth.

Stress, sleep deprivation, self-consciousness about body image, postpartum depression, low libido, healing from vaginal lacerations / episiotomies, pelvic pain, vaginal bleeding, painful intercourse, vaginal dryness, and lactation issues / breast pain are just a few of the issues new moms may be struggling with.  Many of these symptoms are related to sudden, severe hormone shifts that occur after delivery. This totally normal and temporary reduction in estrogen during this period may reduce sexual arousal, reduce vaginal blood flow, decrease lubrication, and result in thinned vaginal tissue. Associated changes in pH and vaginal microbiome can even be associated with change in vaginal odor or discharge. Often women are told to relax, or to “just use some lube” to help ease the discomfort of intercourse after childbirth. But, of course, neither new mothers nor their (likely similarly confused and overwhelmed) partners, relish instruction to simply ‘endure’ sexual activity in this period. Fortunately, by addressing the causes, it is absolutely possible for couples to restore this component of intimacy in the postpartum period as they celebrate and navigate life with their new human together.


Problem: Vaginal dryness 

Cause: Suppressed estrogen and testosterone that occurs after childbirth and during lactation

Treatment: Daily vaginal moisturizers such as hyaluronic acid (HA) which is produced by the body naturally and critical to the retention of moisture in living tissues. Restoration of this essential lubricant can resolve many symptoms and restore comfort and improve sexual function. When combined with Estriol, which is an alternative to higher dose vaginal estrogen, HA can help restore vaginal pH and hormone balance postpartum.

Problem: Pain with intercourse, called dyspareunia.

Cause: Can be caused by the decrease in estrogen and testosterone that occurs after childbirth and during lactation, scarring of ligaments after childbirth or pelvic surgery, or tightening of pelvic floor muscles called vaginismus.

Treatment: Daily vaginal moisturizers such as Hyaluronic Acid (HA) which is produced by the body naturally and critical to the retention of moisture in living tissues. Restoration of this essential lubricant can resolve many symptoms and restore comfort and improve sexual function. When combined with Estriol, which is an alternative to higher dose vaginal estrogen, can help restore vaginal pH and hormone balance postpartum. Using proper lubrication during sexual activity can help as well.

A qualified pelvic floor physical therapist can evaluate the muscles and determine the underlying cause of sexual dysfunction. If tight pelvic floor muscles are to blame, pelvic PT can release trigger points in these muscles and work to restore them to normal function.

Problem: Low sex drive after birth

Cause: Low sex drive after pregnancy is a normal phenomenon caused by increases in oxytocin and prolactin that occur with breastfeeding, and decreases in estrogen and testosterone after childbirth. These evolutionary hormone shifts promote maternal bonding (oxytocin) and relaxation (prolactin) during breastfeeding, and decrease libido as nature’s way to ensure new mothers focus on their new baby before trying for another.

Usually within several months postpartum hormones begin to return to normal levels and sex drive may begin to increase. In some cases, a low libido that occurs for more than 6 months can indicate Hypoactive sexual desire disorder (HSDD). It is important to note that to be classified as HSDD a woman does not think about sex, does not want to have sex, and is bothered by her lack of interest in sex.

Treatment: A low sex drive in the first several months after childbirth is normal and as hormones return to normal levels this usually improves However, if a woman experiences a prolonged lack of interest in sex, it is advisable to talk to a medical provider to discuss symptoms and discuss possible treatment options including therapy or medication.


**There are several other medical conditions that contribute to postpartum sexual dysfunction and lack of desire. Postpartum depression should not be confused with a low sex drive. Postpartum depression is a serious medical condition that requires prompt treatment.

Call your doctor, nurse, midwife, or pediatrician if:

  • Your baby blues don’t go away after 2 weeks
  • Symptoms of depression get more and more intense
  • Symptoms of depression begin within 1 year of delivery and last more than 2 weeks
  • It is difficult to work or get things done at home
  • You cannot care for yourself or your baby (e.g., eating, sleeping, bathing)
  • You have thoughts about hurting yourself or your baby

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