Many women who come to see me in clinic will report that sex has been painful when they tried it again after having their c section (often when it had never been painful before being pregnant). So if this is you, rest assured it is a common one, but the good news is there are lots of things you can do to improve things.
Why can sex be painful post C section?
There is no one definitive answer but i have some theories if you would like to check them out?
Vaginal dryness– after having a baby and especially if breastfeeding, the body is lower in Oestrogen. One of the roles of oestrogen is to keep our vagina more robust and moist! So vaginal dryness and atrophy (slightly shrunken vaginal tissues) is common whilst postnatal/breastfeeding and therefore sex can be more uncomfortable and sensitive. There are some really decent lubricants out there which can help with this. Links are below.
Protective guarding– Many women are concerned about their C scar and will adopt a protective “tensioning” of the abdominals and pelvic floor without realising. This tension/holding pattern will lead to a tightened, shorted pelvic floor. A pelvic floor that has “forgotten” how to relax will make penetrative sex more uncomfortable. So try massaging your tummy and your scar (see previous C section series post on this) as this can have a good knock-on effect for your pelvic floor to relax. Belly breathing will also help- see below.
Breath holding- It also common to breath hold/breathe more shallowly after having a baby. The baby was high up under our diaphragm and our tummies were on a constant stretch, so sometimes we forget that we can re-claim that belly and breath deeply again. The diaphragm and the pelvic floor move together when we breathe so practising belly breathing will allow diaphragm to move through its full range of movement and stretch our pelvic floor. So practice belly breathing (lie down in comfortable position and rest your hand on your tummy. Feel your tummy rise as you inhale and fall as you exhale) – then try it during sex and see if it helps!
Postnatal Yoga is a great way to tick the boxes including breathing, relaxation, stretching and pelvic floor release. It can usually be started between 6-12 weeks post c section.
Links to Lubes!
https://www.stressnomore.co.uk/pjur-woman-bodyglide-lubricant-81223.html This one is compatible with latex.
https://www.stressnomore.co.uk/olive-bee-intimate-cream-12317.html This one is not compatible with latex, also great to use a a daily moisturiser.
If you are still withpainful sex after a C section, then come and see a pelvic/womens health physio. We can go through the above with you and check your C scar. We can also use internal techniques to assess your pelvic floor muscles and use manual therapy to help them to release.