Restoring Comfort and Confidence for Postpartum Intimacy
TL;DR
Guest post by pelvic-health physical therapist Chelsea Speegle on returning to sex after the postpartum medical clearance. Anxiety is common and understandable, and she suggests talking openly with your partner, remembering that sex need not involve penetration, and using tools such as Ohnut rings and dilators. She also recommends water-based or silicone lubricant for postpartum estrogen-related dryness, plus pelvic floor physical therapy and a sex therapist for support.
You just returned from your 6 week follow up appointment with your medical provider and they cleared you to return to activities and sex. What thoughts and feelings may you be experiencing? Are you excited? Or hesitant? Maybe nervous or scared? There are some who may be thrilled and get right back to it. That’s great! BUT many birthing individuals are on the other side experiencing feelings of anxiety and fearfulness. These feelings are common and completely understandable. You just birthed a baby! Allow yourself some grace. However, let’s discuss ways to help prepare for sex postpartum.
Communication
This is key!!! Communicate with your partner on your feelings towards sex. Discuss with them on what you. May or may not be ready for. Sex does not have to involve penetration. It can involve foreplay, kissing, oral, or manual stimulation etc. If you find it difficult to communicate with your partner about intimacy, it would be helpful to schedule a session with a sex therapist. They can provide guidance in communication for you and your partner and ease any anxiety around sexual intimacy.
Tools
There are several types of tools nowadays to not only help with pelvic floor recovery but also to help penetrative sex be more comfortable. Ohnut is a popular tool that involves placing flexible rings around a penis to control the depth of penetration. Dilators are devices of various sizes ranging from smaller than a tampon to the size of a penis to gradually improve tissue mobility for initial and deep penetration. Condoms are another tool to use in case you opt out of birth control.
Lubricants
Did you know that estrogen decreases during postpartum? It typically does not return to normal levels until 6 months postpartum or until cessation of breastfeeding. Decreased levels of estrogen create vaginal dryness, tightness, and tenderness. Utilizing lubricants can help with comfort during sex. There are different types of lubricants but two of the highly recommended types are water based and silicone based. Water based has a more natural feeling but does not last as long so may need reapplication. Silicone based is a bit more expensive but does not absorb into the skin so is longer lasting.
Pelvic Floor Physical Therapy
Many people see a physical therapist to rehab shoulders, knees, back etc. from surgery or injuries. The pelvic floor is no different. Giving birth to a baby, whether vaginally or cesarean can impact the pelvic floor and therefore needs rehabilitation. Sex is a function of the pelvic floor so, of course, pelvic floor physical therapists help with this! Pelvic floor physical therapists address the body as a whole but specifically the pelvic girdle and pelvic floor muscles improving any dysfunctions related to the pelvic floor, even sexual function! Pelvic floor physical therapists provide guidance in using tools and release techniques to reduce any scar tissue adhesions or pelvic floor muscle tension that may contribute to pain with sex.
There is a lot of fear and anxiety surrounding return to sex postpartum. However, there is information and resources are to improve any negative emotions associated with sex postpartum. Do not be afraid to reach out to a sex therapist/counselor or a pelvic floor physical therapist regarding questions or concerns surrounding sex. We are here to help!
Disclaimer: The views expressed in this post are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decision.
