Don’t Settle For Pain With Sex

These Are True stats:

  • 64% of women report sexual dysfunction during their first year post-partum.
  • 24% of women still have dyspareunia (painful sex) at 18 months post-partum.
  • Women who birth via Cesarian are 2x as likely than women with vaginal deliveries to experience painful sex at 18 months post-partum.

It’s normal for the first few sessions of post-partum sex to feel uncomfortable or feel different for a variety of reasons – after all, you just had a baby. But if pain persists or worsens, it needs to get checked out.  Don’t put up with it because pain is not part of normal sexual functioning.  (This is true across the board, whether you’ve had a baby or not).   If you have pain with sex, your body (or heart/mind/spirit)  is usually trying to tell you something.

What causes pain during or after intercourse?
​It can be a number of things such as:

  • scar tissue
  • internal tender points on the vaginal walls
  • internal muscle tightness or spasming
  • hormonal changes
  • chemical changes
  • imbalance of gut and/or vaginal flora
  • infections or diseases
  • micro tears due to thinning or sensitive vulvo-vaginal tissue
  • weakness of the pelvic floor muscles
  • dysfunction in the lumbar-pelvis-hip unit
  • fascial or connective tissue dysfunction
  • nerve irritation or compression
  • a dysfunctional core canister
  • or more.

Fact: pain changes your brain, and your brain changes pain.
The list above focuses on physical structures that we can touch or biological processes that we can test.  Yet there are  emotional, mental, social and spiritual components to sex as well; and they are arguably more important for cultivating intimacy than the physicality of it all.

In the same way that sexual function is multi-faceted, so is pain.  Pain is very much a physical experience, but it is also regulated by pshyco-social-emotional-spiritual  factors.   And what coordinates the many dimensions of pain? Ultimately, it’s the brain.

Classic example – you’ve heard of phantom limb pain where an amputee feels sensations or pain in a limb that no longer exists.  Imagine trying to scratch an itch on an arm that has been removed.  Torture, right?   Although that limb no longer exists physically, the representation of that limb on the brain continues to exist. It therefore can still allow for various sensations to be experienced by the individual.

Or another example – perhaps you’ve stubbed your toe while throwing an adult temper tantrum. That toe hurts a helluva lot more when you’re angry or stressed out than when you’re doing a happy dance because you just won the lottery.

Childbirth, sex, pain, and the brain.
So what is the connection sex, childbirth, pain and the brain?  To oversimplify,  the brain links certain experience (such as childbirth or sex) with the pelvic region.  Negative memories, fears, trauma,  disappointments, etc are “stored” there and may result in the experience of pain.  Therefore thoughts and feelings (whether conscious or subconscious) about a past experience or an upcoming experience can perpetuate, magnify and intensify the experience of pain.

For example:

  • You experience pain during childbirth  perhaps due to tearing or an episiotomy. You have negative feelings about the pain.
  • From that experience, you start to believe that you’re “too tight”.  Maybe your nurse casually said something to suggest that.
  • You have sex for the first time after baby and it hurts perhaps due to some scar tissue or tissue dryness from hormonal changes.  But you also believe that you’re too tight.
  • Because sex is painful, your brain concludes that sexual activity is a threat to your system.
  • The next attempt at intercourse arrives and is accompanied by apprehension, uncertainty about what is going on with your body, fear that damage could be done, lack of sexual confidence, relational tension, and the memory of that painful first attempt.
  • When our systems are under stress or are faced with a threat, we go into freeze, flight, or fight mode.
  • In this case, you subconsciously go into a self-protective mode.  This translates into muscle tension and  guarding in the muscles of the pelvic floor (and likely the rest of your body).
  • So although you may not have ever been “too tight”, your body and pelvic floor now tighten up in anticipation of pain.
  • You attempt sex a 2nd time and now penetration hurts even more.
  • Every time you attempt have sex it becomes more and more painful and you become more and more anxious.
  • This leads you to believe there is a major problem with your body.  You go for tests and scans and the doctors find nothing. Everything looks normal, they say.
  • You start to wonder if you’re going crazy and if it’s all in your head….

…thus the vicious cycle begins. It can be crippling and can completely devastate you and your relationship.

Healing Is Possible
In the same way that thoughts, emotions and one’s spiritual state can affect tissues of the body negatively,  they can also affect the body positively.
To successfully treat pain with intercourse, we must treat the tissues of the body.  But we must also explore other components such as your thoughts, feelings, and beliefs about your experience.  Adopting a bio-psycho-social approach to the treatment of persistent sexual pain will help you to fully heal.

If you are experiencing pain with sex, don’t stand for it.  You deserve better. Your relationship deserves better.  And YOU. ARE. WORTH. IT!
Please book an evaluation with us to uncover the underlying reasons you may have pain during sex,  and get ready to turn post-partum pain to post-partum pleasure.

You’ll be surprised  – your sex life after baby can be better than you ever expected!

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ibbie here!

Just a physiotherapist with a passion for birth, pregnancy, postpartum, and pelvic health…and apparently the letter “P”.

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