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It’s time to talk about peripartum sexual health

So you’re pregnant and in baby mode. You know the books to read and must-have registry items. But something not as readily discussed is your sexual health during the peripartum period (meaning right before, during and immediately after giving birth). What should you expect and what is “normal”?

Tryon Medical Partners’ Nurse Practitioner Lindsey Mosley specializes in gynecology and sexual health at Tryon Women’s Center and provides you with answers to the questions you haven’t thought of yet or may be too afraid to ask.

Some women are interested in having sex during the peripartum period. And some aren’t. Both are normal.

After being pregnant for nine months and now caring for an infant, the thought of intercourse may be the last thing on your mind. This is common as your body experiences so many physical and hormonal changes and is not something to feel bad about. And conversely, others may very well be looking forward to resuming their sex life but find it painful and don’t know why.

It’s not uncommon to now experience pain with intercourse.

There are a variety of reasons you may be feeling discomfort but the good news is you can find the proper relief. Hopefully, you already have a clinician who knows your medical history and with whom you feel comfortable. If you don’t, try to establish one, as this relationship allows you the opportunity to discuss any issues you may be having, including your sexual health. 

According to Lindsey, pain during intercourse could be related to several different things, including birth control pills, back and hip pain, hormonal changes or pelvic floor issues.

“We spend a lot of time talking with patients in the initial appointment to figure out what is going on,” says Lindsey. “The rest of the exam and treatment course is based on what we learn.”

Treatment options for sexual discomfort will vary depending upon the underlying cause.

Changes to the pelvic floor are common in pregnancy due to the additional weight being carried. If it is determined that the pain is pelvic-floor related, it’s recommended to hold off on intercourse and start physical therapy (PT). At Tryon, your clinician will watch how you walk, sit and stand, as well as check your pelvis, to help pinpoint if this is the issue and PT can be of help.

Some women experience trauma during delivery. This may include natural tearing of the vaginal opening or if the vaginal opening needs to be cut. Additionally, scar tissue can be an issue. Any physical trauma can lead to pain with intercourse. 

Hormone fluctuations are very common and for many women, low hormones can contribute to painful intercourse. Speak with your clinician to find potential treatment options.

Myths exist about peripartum sexual health and they need to be busted.

“Life is different after delivery,” shares Lindsey. “You’re exhausted and your libido can change dramatically. You’re overstimulated, over touched, and you are expected to be a good partner. It’s really hard.”

It’s helpful to ensure an open, honest and communicative relationship with your partner. Working together to address any issues will help in the long run.

Your sexual health can be improved by remembering a few key things.
  • Don’t be afraid to ask questions. “No question is off the table,” says Lindsey. “If you don’t ask your doctor, we won’t know.”
  • Advocate for yourself. You need to feel heard if you have concerns. Things can get lost in the shuffle when you’re focusing on your baby but it’s very important to speak up.
  • For most women who are interested, intercourse during pregnancy is very safe. There are few instances where a woman will need to refrain from sexual activity, and your doctor will advise you if this is the case.
  • Postpartum depression is real. If you feel that something isn’t right, something isn’t right. Lindsey adds, “If you’re not enjoying life, can’t get out of bed, can’t take care of the baby, you’re not communicating with your partner and your doctor … It’s important to address your mental health, which may end up improving your libido as well. If you’re experiencing any mental health issues, having intercourse will not be at the top of the priority list.” 

Questions about your sexual health? Speak to a specialist at Tryon Women’s Center to help find answers.