Postpartum Pain and Sexual Activity: Healing and Discomfort

Postpartum wounds and sexual intercourse?

Hello Doctor, I gave birth 8 months ago (first child, vaginal delivery).
Currently, my baby is exclusively breastfed.
I would like to ask you, after about 2 months postpartum, I experienced pain and a tearing sensation during intercourse, which I thought was due to the wound not healing yet.
However, when I went back to the hospital for a check-up, the doctor said everything was fine.
A month later, I still experienced pain during intercourse.
Now, 8 months later, I still feel a tearing sensation during intercourse, although the pain is now within a tolerable range.
Additionally, I feel that my vagina is very dry, making the intercourse uncomfortable.
I would like to ask two questions: First, what is the condition of the wound? Second, regarding the vaginal dryness, I read online that it may be related to breastfeeding; is this correct? Thank you for your clarification.

Ms. Zhang, 30~39 year old female. Ask Date: 2016/01/08

Dr. Lü Lizheng reply Obstetrics and Gynecology

Based on personal experience, it may be vaginitis.
Therefore, even if the examination shows that the wound has healed, inflammation can cause discomfort during intercourse.
It is recommended to seek medical treatment.
In the short period after childbirth, a decrease in hormones may lead to vaginal dryness, which will typically resolve over time.
Breastfeeding can temporarily suppress ovulation, resulting in lower hormone levels, but ovulation will resume after some time, normalizing hormone levels.
If dryness persists, it may indicate vaginitis or other issues, and medical treatment is advised.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/01/08

More Info

Postpartum pain and discomfort during sexual activity can be a significant concern for many women, especially after experiencing childbirth. Your situation, where you are experiencing persistent pain and discomfort during intercourse eight months postpartum, is not uncommon, and it's essential to address both the physical and psychological aspects of this issue.

Firstly, regarding the pain you feel during intercourse, it’s important to understand that the healing process after childbirth can vary significantly from one woman to another. Even if your doctor has confirmed that your physical healing is progressing well, it is possible that you may still be experiencing discomfort due to several factors. These can include:
1. Scar Tissue: If you had any tearing during delivery, scar tissue can form as it heals. This scar tissue may not be as elastic as the surrounding tissue, leading to discomfort or a tearing sensation during intercourse.

2. Vaginal Atrophy: After childbirth, especially if you are breastfeeding, hormonal changes can lead to vaginal dryness and atrophy. Estrogen levels drop during breastfeeding, which can cause the vaginal tissues to become thinner and less lubricated, resulting in discomfort during sexual activity.

3. Pelvic Floor Dysfunction: The pelvic floor muscles can be weakened or overly tense after childbirth, which may contribute to pain during intercourse. If these muscles are not functioning correctly, they can lead to discomfort or a sensation of tightness.

4. Psychological Factors: Sometimes, anxiety or fear related to pain can create a cycle of tension that exacerbates discomfort during intercourse. If you have had painful experiences in the past, it may lead to increased anxiety during sexual activity, which can further contribute to discomfort.

Now, addressing your specific questions:
1. Regarding the condition of your healing: If your doctor has assessed your healing and found no issues, it may be beneficial to seek a second opinion or consult a pelvic floor specialist. They can evaluate for any underlying issues such as pelvic floor dysfunction or scar tissue that may not have been addressed.

2. On the issue of vaginal dryness: Yes, it is accurate that breastfeeding can lead to vaginal dryness due to decreased estrogen levels. This is a common issue for many breastfeeding mothers. To alleviate this discomfort, consider using water-based lubricants during intercourse to enhance comfort. Additionally, discussing this with your healthcare provider may lead to other solutions, such as vaginal moisturizers or hormonal treatments if appropriate.

In conclusion, it’s crucial to communicate openly with your healthcare provider about your ongoing discomfort. They can provide a thorough evaluation and recommend appropriate treatments or therapies. Remember, postpartum recovery is a journey, and it’s essential to prioritize your comfort and well-being. Seeking support from a pelvic floor therapist or a sexual health specialist can also be beneficial in addressing both the physical and emotional aspects of your experience.

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