Postpartum Pain During Intercourse: When to Seek Medical Advice?

Pain during intercourse?

Hello Director Chen, my wife had a natural delivery on May 12.
After that, on June 15, we attempted intercourse, but she experienced pain.
Later, we discovered a 2 cm long laceration from the vagina to the anus (which is the cause of the pain).
The wound is not bleeding.
Could you please advise how long after a natural delivery is it safe to resume intercourse, and whether the vaginal laceration requires medical attention? Thank you.

An An, 20~29 year old female. Ask Date: 2007/07/10

Dr. Chen Changfu reply Obstetrics and Gynecology

Women who have natural childbirth often have wounds in the perineal area, which heal quickly after suturing.
However, during the initial healing phase, the scar tissue can be tighter, leading to a sensation of pulling pain.
This tightness also serves to protect the wound, preventing it from tearing when the surrounding tissue is still fragile.
Generally, it takes about six weeks postpartum for a woman's physiological and pelvic floor muscle elasticity to recover.
It is recommended to wait until six weeks after delivery to resume sexual activity, as this can help avoid the frustration of pelvic floor muscle laxity.

Reply Date: 2007/07/10

More Info

Postpartum pain during intercourse is a common concern for many women after giving birth. In your case, it appears that the pain is associated with a 2-centimeter laceration or episiotomy that has not fully healed. It is essential to understand the healing process and when to seek medical advice regarding postpartum sexual activity.

Generally, healthcare providers recommend waiting at least six weeks after a vaginal delivery before resuming sexual intercourse. This timeframe allows for the uterus to return to its pre-pregnancy size, the cervix to close, and any vaginal tears or episiotomies to heal adequately. However, individual healing times can vary significantly. Factors such as the extent of the laceration, overall health, and any complications during delivery can influence recovery.

In your situation, since you have identified a specific area of pain related to a laceration, it is crucial to monitor the healing process. If the laceration is still painful during intercourse, it may indicate that it has not healed properly or that there is some underlying issue, such as infection or scar tissue formation. Here are some key points to consider:
1. Pain During Intercourse: Experiencing pain during intercourse, especially if it is localized to a specific area like a laceration, is not normal. It is essential to address this issue with your healthcare provider.

2. Healing Assessment: If the laceration is still present and causing discomfort, it may require a medical assessment. A healthcare provider can evaluate the wound to ensure it is healing correctly and not infected. They can also provide advice on pain management and alternative methods to engage in intimacy without discomfort.

3. Signs of Infection: Watch for any signs of infection, such as increased redness, swelling, warmth, or discharge from the laceration site. If you notice any of these symptoms, seek medical attention promptly.

4. Follow-Up Care: If you have not had a postpartum check-up yet, it is advisable to schedule one. During this visit, your healthcare provider can assess your overall recovery, including the status of the laceration, and provide guidance on when it is safe to resume sexual activity.

5. Communication with Partner: Open communication with your partner about your discomfort is essential. It may be helpful to explore other forms of intimacy that do not involve penetration until you feel more comfortable.

6. Pelvic Floor Exercises: Engaging in pelvic floor exercises (Kegel exercises) can help strengthen the pelvic muscles and may improve comfort during intercourse over time. However, consult your healthcare provider before starting any new exercise regimen postpartum.

In summary, if you are experiencing pain during intercourse due to a laceration from childbirth, it is crucial to seek medical advice. Your healthcare provider can assess the healing process, address any concerns, and provide recommendations tailored to your specific situation. Remember, prioritizing your comfort and health is essential during the postpartum recovery phase.

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