Welcome to Moments with MamasteFit! In this episode, perinatal fitness trainer and birth doula Gina, alongside pelvic floor physical therapist Hayley Kava, discuss common causes and solutions for painful sex in the postpartum period. Intimacy after childbirth can be a complex and emotional experience. Whether you’re feeling nervous, experiencing discomfort, or unsure of what to expect, you’re not alone. Many postpartum individuals struggle with painful sex, but the good news is that there are ways to address and resolve it!
Why Does Sex Hurt After Birth?
After giving birth, many individuals notice changes in their body that can make intimacy uncomfortable or even painful. Here are some common reasons why sex might hurt postpartum:
1️⃣ Hormonal Changes & Vaginal Dryness
- Estrogen levels drop dramatically after birth—this is the biggest hormonal shift in a woman’s lifetime.
- Lower estrogen levels affect natural lubrication, leading to vaginal dryness.
- You may also notice dry eyes, dry nasal passages, and even shrinking of the labia minora or clitoris due to reduced estrogen.
💡 Solution: Consider using vaginal moisturizers, topical estrogen (if recommended by your provider), and high-quality lubricants.
2️⃣ Pelvic Floor Tension & Muscle Tightness
- Childbirth, whether vaginal or cesarean, can lead to increased pelvic floor tension.
- If tissues are irritated or scar tissue is present (from perineal tears or C-section incisions), muscles may tighten in response, leading to discomfort.
💡 Solution: Gentle pelvic floor exercises, massage, and deep breathing techniques can help. A pelvic floor physical therapist can guide you through tailored movements to release tension.
3️⃣ Scar Tissue & Nerve Sensitivity
- If you experienced a perineal tear, episiotomy, or C-section, the healing process can cause scar tissue buildup, making sex painful.
- The tissue around the clitoris and vaginal entrance may also feel hypersensitive or numb.
💡 Solution: Pelvic wands and perineal massage can help release tension in the scar tissue and improve comfort.
4️⃣ Psychological Factors & Fear of Pain
- If you’ve experienced painful sex once, your body may anticipate discomfort, leading to involuntary muscle tightening.
- Emotional concerns like body image struggles, exhaustion, or fear of intimacy after birth can also contribute.
💡 Solution: Open communication with your partner and mentally preparing for intimacy can ease tension. If needed, a therapist specializing in postpartum relationships can help.
How to Make Sex More Comfortable Postpartum
If you’re experiencing discomfort, you don’t have to suffer through it. There are several ways to make sex feel better and even enjoyable again!
1️⃣ Use the Right Lubricant
Lubrication is essential for comfortable sex postpartum. Hayley Kava recommends:
✔️ Silicone-based lubes: Long-lasting and moisturizing (Recommended: UberLube)
✔️ Water-based lubes: Safe and easy to clean (Avoid glycerin-based lubes)
✔️ Hyaluronic acid-based vaginal moisturizers: Great for daily hydration (Recommended: Good Clean Love)
❌ Avoid coconut oil, as it can create a breeding ground for bacteria.
2️⃣ Experiment with Different Positions
Certain positions can put extra strain on the pelvic floor, making sex more painful.
If deep penetration is painful:
✅ Try keeping knees closer together instead of wide apart
✅ Avoid excessive arching of the back (helps reduce tension in pelvic floor muscles)
✅ Use pillows or a wedge for extra support (Recommended: Liberator Wedge Pillow)
💡 Tip: Positions that allow for shallower penetration (like spooning or missionary with a pillow under your hips) may feel more comfortable.
3️⃣ Try Pelvic Floor Relaxation Techniques
Since pelvic floor tightness can exacerbate pain, releasing tension can help:
Deep breathing exercises before intimacy
Gentle inner thigh activation to promote relaxation
Pelvic wands or perineal massage to reduce scar tissue tightness
💡 Bonus: These techniques increase blood flow to the clitoris and vaginal walls, enhancing pleasure.
4️⃣ Don’t Rush Foreplay (or Use Lube to Speed It Up!)
If you’re feeling exhausted from parenting and don’t have time for long foreplay sessions, lubricant is your best friend.
💬 Gina’s take on this:
“As a mom of four, I don’t always have time for 20 minutes of foreplay! If I’m already dry, I just lube up and go. No shame in that!”
💡 The takeaway: Whether you prefer extended foreplay or need a quick solution, prioritizing comfort is key.
Communication Is Key: Talking to Your Partner About Painful Sex
One of the most important steps to overcoming painful sex postpartum is talking openly with your partner.
How to start the conversation:
🗣️ Be honest about your concerns – “I want to be intimate with you, but I’m feeling nervous about pain.”
🙌 Ask for support & patience – “I’d love to try some new positions or use lube to make things more comfortable.”
❤️ Check in with your own emotions – If you feel mentally overwhelmed, let your partner know.
💡 Need more guidance? Listen to our MamasteFit Podcast episode below on postpartum intimacy for expert relationship advice.
When to See a Pelvic Floor Physical Therapist
If you’ve tried these tips and sex is still painful, it may be time to see a pelvic floor physical therapist.
🔹 If you experience burning, stabbing, or sharp pain during penetration
🔹 If you had a C-section, episiotomy, or perineal tear and feel ongoing discomfort
🔹 If you feel tense or unable to relax your pelvic floor muscles
A pelvic floor PT can:
✔️ Help release scar tissue tension
✔️ Teach relaxation techniques for pain-free intimacy
✔️ Provide personalized exercises for pelvic floor function
Final Thoughts: You Deserve Pain-Free & Pleasurable Intimacy
If you’re struggling with painful sex postpartum, you’re not alone, and there is help available.
✔️ Use lube & moisturizers to combat vaginal dryness
✔️ Experiment with positions to find what feels good
✔️ Practice pelvic floor relaxation for better comfort
✔️ Communicate openly with your partner about your needs
✔️ Seek professional help if pain persists
For more postpartum support, check out our MamasteFit Online Programs to help you move pain-free and feel confident in your body after birth. Use code MOMENT10 for 10% off our offerings.
Additional Resources
Hayley Kava’s Resources:
Hayley Kava PT: https://www.hayleykavapt.com/
Instagram: https://www.instagram.com/hayleykavapt/
Pelvic Balance Series: https://www.hayleykavapt.com/Pelvicbalanceseries
Hayley’s Positional Guide for Pain-Free Sex: https://www.hayleykavapt.com/the-sex-position-guide-sales-page
Hayley’s Lube Recommendations:
V-Magic: https://amzn.to/4hOUprK
Good Clean Love: https://amzn.to/4hOUzPS
Coconu: https://amzn.to/4hQ7eCb
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