Understanding Postpartum Dyspareunia: Causes, Symptoms & Treatment Options

Navigating and Overcoming Painful Sex After Childbirth

Congratulations! You’ve made it through pregnancy, childbirth, and the whirlwind that is postpartum life. You’ve survived sleepless nights, adapted to a whole new role (parenting!), and adjusted to a rollercoaster of hormonal changes. But now, just as you’re ready to reconnect with your partner, you’re met with an unwelcome surprise: sex has become painful. If this sounds familiar, you’re not alone. Postpartum dyspareunia, or painful sex after childbirth, is more common than you might think—and there are ways to treat it.

What Is Postpartum Dyspareunia?

Postpartum dyspareunia is the medical term for painful sex after childbirth. It affects more than half of women within 6-12 weeks after delivery, and for some, it lingers for months or even years.1,2 If sex feels uncomfortable or painful, it’s worth exploring why.

Why Does Postpartum Dyspareunia Happen?

Pregnancy and childbirth change your body in significant ways, and it takes time to heal. Here are some common reasons why postpartum dyspareunia happens:

• Breastfeeding: While beneficial for your baby, breastfeeding reduces estrogen levels, which can cause vaginal dryness and thinning of vaginal tissue3
• Vaginal Tears or Injury: Childbirth can result in tears or stitches, leading to scar tissue and discomfort during penetration4
• Pelvic Floor Changes: The muscles supporting your pelvic organs may become strained or weakened, or they might tighten excessively, causing pain
• Fatigue and Stress: Being a new parent is exhausting and stressful, both of which can contribute to painful sexual intercourse
• Hormonal Shifts and Emotional Factors: Postpartum hormonal changes, coupled with psychological factors like anxiety or depression, can play a role

Even if you had a C-section, postpartum dyspareunia can still occur due to hormonal changes or pelvic muscle strain.

Is Vaginismus Connected to Postpartum Dyspareunia?

Vaginismus, a condition where vaginal penetration causes pain due to involuntary muscle contractions, can be triggered by childbirth-related injuries. If you’re feeling intense discomfort or anxiety about penetration, vaginismus could be a contributing factor. Fortunately, there are treatments that can help.

How Long Does Postpartum Dyspareunia Last?

For many women, this discomfort improves with time. Studies show that about 31% of women experience dyspareunia at three months postpartum, and 12% still experience it two years after delivery.5 If pain persists, it’s important to seek help.

What Are the Treatment Options?

The good news? Postpartum dyspareunia is treatable. Here’s what can help5:

• Lubricants and Topical Estrogen: Vaginal dryness can be addressed with over-the-counter lubricants or prescription estrogen creams. Talk to your healthcare provider to see what’s best for you
• Pelvic Floor Physical Therapy: A trained therapist can teach you exercises to strengthen or relax your pelvic floor muscles, easing discomfort
• Vaginal Dilators: These tools gently stretch and condition your vaginal muscles, helping to make penetration less painful over time.5
• Therapy: Stress and fatigue can take a toll. Speaking with a postpartum therapist can help you navigate emotional and physical challenges
• Consult Your Healthcare Provider: They can check for underlying conditions and recommend the best treatment plan for your needs

When to Seek Help

If you notice persistent pain, increased bleeding, a foul odor, or other unusual symptoms, don’t wait to contact your doctor. Early intervention can prevent complications and make your recovery smoother.

Final Thoughts

Postpartum dyspareunia is a reminder to take it slow and give your body the time it needs to heal. Rest, seek support when you need it, and don’t be afraid to talk to your healthcare provider. Painful sex after childbirth isn’t something you have to endure forever—there are solutions, and you deserve to feel good in your body again.

How Milli Can Help

If you are ready to take control of postpartum discomfort and you think it might be related to unconscious clenching of vaginal muscles (vaginismus), the Milli vaginal dilator may be able to help you find relief. The innovative design of this all-in-one expanding vaginal dilator gently expands and conditions your vaginal muscles at your own pace (pssst, it even has a vibration setting). With consistent use, you may feel more comfortable and in control of your body. 

Visit our web site for further resources and support.

1. Lagaert L, Weyers S, Van Kerrebroeck H, Elaut E. Postpartum dyspareunia and sexual functioning: a prospective cohort study. Eur J Contracept Reprod Health Care Off J Eur Soc Contracept. 2017;22(3):200-206. doi:10.1080/13625187.2017.1315938
2. Rosen NO, Dawson SJ, Binik YM, et al. Trajectories of Dyspareunia From Pregnancy to 24 Months Postpartum. Obstet Gynecol. 2022;139(3):391-399. doi:10.1097/AOG.0000000000004662
3. Alligood-Percoco NR, Kjerulff KH, Repke JT. Risk Factors for Dyspareunia After First Childbirth. Obstet Gynecol. 2016;128(3):512-518. doi:10.1097/AOG.0000000000001590
4. Gommesen D, Nøhr E, Qvist N, Rasch V. Obstetric perineal tears, sexual function and dyspareunia among primiparous women 12 months postpartum: a prospective cohort study. BMJ Open. 2019;9(12):e032368. doi:10.1136/bmjopen-2019-032368
5. Macey K, Gregory A, Nunns D, das Nair R. Women’s experiences of using vaginal trainers (dilators) to treat vaginal penetration difficulties diagnosed as vaginismus: a qualitative interview study. BMC Womens Health. 2015;15(1):49. doi:10.1186/s12905-015-0201-6
6. MKT3446 Understanding Postpartum Dyspareunia: Causes, Symptoms, and Treatment Options