Many women have sexual difficulties after childbirth, such as pain and diminished sex drive.
Generally, women are told to wait about six weeks after childbirth before having vaginal intercourse again. However, even after this time period, some women experience pain with intercourse. They may still have stitches, making the area tender. Vaginal lacerations and episiotomies (surgical cuts that enlarge the vaginal opening to make delivery easier) may still be healing. Some women develop infections or tumors that can cause pain.
One of the most common causes of pain is vaginal dryness. This can happen because of hormonal changes after childbirth. When a woman is breastfeeding, estrogen and testosterone are suppressed, which can lead to lubrication problems and a thinning of the vaginal lining.
Some women find that moisturizers or lubricants can help with vaginal dryness. Moisturizers rehydrate vaginal tissue so that it becomes more elastic, although this can take about two months.
Lubricants add moisture and lessen friction in the vagina. They are used each time a woman has sex. They may be water-, silicone- or oil-based. Some lubricants need to be used with caution. For example, oil-based lubricants are not safe to use with latex condoms. Water- and silicone-based lubricants may contain glycerin, which can cause yeast infections or inflammation.
Estrogen therapy, in the form of a cream, ring, or pill, is another option for treating vaginal dryness.
Low sex drive can also occur after childbirth. This may have several causes: a woman many be exhausted caring for a new baby; suppressed testosterone levels may interfere with her libido; or she may have postpartum blues or depression.
Exercising, eating healthy foods, and spending time with friends can all help. A woman may seek support for postpartum blues by talking to other mothers. If she has depression, she might try counseling.