Pregnancy and childbirth can be an amazing experience for women, but it can also cause some intimate issues postpartum. First and foremost, know you're not alone, mama, and find a trusted healthcare professional you can talk with honestly. And, remember if you have urgent concerns, consult with your doctor.
Here are some common situations and tips on how to handle them in your postpartum recovery.
1. Diminished sex drive
Not having the urge to have sex can happen for a couple of reasons. First of all, there are tons of hormonal changes a woman has to deal with postpartum. It can take up to three months after childbirth for your hormones to rebalance and even longer if you're breastfeeding. Specifically, the hormones produced in lactating mamas suppress estrogen and testosterone and this lowers desire and can cause vaginal dryness.
Some ways to deal with the hormonal effects are by using over the counter vaginal moisturizers or using a prescriptive vaginal cream to replace estrogen. Exercise and sleep have also been found to be helpful tools to improve overall health and sexual desires.
Pain can be another causative factor. Women often feel pain in the pelvic floor muscles from birth trauma and it can be painful to have intercourse. Additionally, those who have larger tears often feel pain where they have stitches and scars.
To relieve pelvic floor muscle spasms, women can try the following:
1. Take a warm bath to relax the muscles prior to intercourse.
2. Try doing the child's pose and deep squats to help lengthen the pelvic floor muscles.
3. Breathing exercises and meditation may help.
4. If pain persists, consider treatment with a women's health physical therapist.
To relieve scar pain:
Sometimes self-massage techniques with a massage wand can relieve or desensitize painful scars. Start using gentle circular stokes above and below the incision for about two minutes for a week. Then add massaging the incision the following week. It may take a few weeks to a month to desensitize the scar tissue.
If the scars are raised and feel ultra sensitive, doctors might prescribe hydrocortisone cream to be used for a week to decrease the pain and inflammation or consider a procedure to burn away the extra tissue and promote healing.
It's completely normal to lose temporary control of gas when the pudendal nerve has been damaged or compressed as a result of the baby passing through the vaginal canal. When this happens the pelvic floor muscles can become weak and are not strong enough to control passing gas. This can be particularly upsetting if a woman loses stool.
Normally, this should resolve in a few weeks. But if not, you can try a self-treatment technique. Use the "Happy Baby Pose," where you lie on your back and bring legs with bent knees towards the chest. Then place her hands on the inside of the shin to hold the legs and points and flexes the foot to help mobilize the pudendal nerve—physical therapists refer to this as nerve flossing. Gentle Kegel exercises may help to activate and strengthen the weak pelvic floor muscles as well.
If you're still having issues after a few weeks, or not finding self-treatments working, consult with your doctor. You can also look to a women's health physical therapist who can help you mobilize the nerve and teach you how to reactive the pelvic floor muscles.
3. Vaginal Farts or postpartum "queefing"
After childbirth, the vaginal canal is stretched out and it can take a while to resume its normal or almost normal size again. It can take longer in lactating women because they are still under the influence of hormones that causes connective tissue to loosen up.
Fortunately, this should resolve within a month or two. If not, let your doctor know. You can also try pelvic floor strengthening exercises, listed above, and avoid placing too much stress on those muscles, such as lifting heavy or returning to high impact exercises.
4. Incontinence—leaky bladder
Many women develop stress incontinence after childbirth, where they leak urine when they cough, sneeze, laugh, run and jump. To combat stress incontinence, try gentle Kegel exercises to help strengthen pelvic floor muscles. You can also prevent straining the pelvic floor muscles by exhaling upon exertion. The amount you should exhale should match the effort needed to perform a task. So exhale gently when lifting a newborn, but more deeply when lifting a heavy bag of groceries. Another important thing is use good toileting habits. This includes resisting the temptation to push urine out when urinating because it can strain pelvic floor muscles.
A full exercise program can also include postural restoration exercises, breathing exercises and core exercises that focus on deeper abdominal and pelvic floor strengthening.
There are many things a body goes through after giving birth. Fortunately, most of them are completely normal. However, if you're noticing something isn't improving or you're feeling a bit more concerned, it's important to discuss those problems with your health care provider as it may be an indication of something more serious. Together, you can find a recovery plan that works best for your specific needs.