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Top 3 Reasons for Pain With Sex Postpartum

Pain with (vaginal penetrative) sex is very common postpartum, but can affect women at all ages and stages of life.

It is never considered normal to have pain with sex, and even one painful experience can result in trauma and chronic guarding, which can create a cycle of pain later on.

There are several causes for pain with sex postpartum

Scar Tissue

Tearing during birth can create scar tissue adhesions in the vagina. The vagina needs to be able to fully expand symmetrically in all directions for penetration, and when one aspect is tight and adhered from scar tissue, pain and bleeding can be the result.

Painful intercourse due to scar tissue often resolves at the end of the fourth trimester, or 12 weeks postpartum, but not always.

Scar tissue needs to be massaged regularly to restore mobility in the vaginal wall, and this should begin as soon as the wound has fully healed.

That said, it's never too late to start working on scar tissue adhesions.

Vaginal Dryness

Estrogen is suppressed during breastfeeding, which can create a lack of lubrication to the vaginal tissues, also known as vaginal dryness.

This occurs when women are not menstruating due to breastfeeding or menopause.

The result is thin and dry vaginal tissues. In more severe cases, dryness can create irritation along the vulva when wearing clothing.

In cases of vaginal dryness, penetrative sex can feel very painful and burn, especially around the urethra as the skin is very thin and sensitive.

This can also result in microtearing of the tissues, creating an increased risk for bacteria to enter and cause a urinary tract infection.

Most of the time, hormone levels even our fairly quickly postpartum and pain from vaginal dryness can be improved with a lot of lubrication.

Occasionally, however, moms will need to seek out a topical estrogen cream from their primary care providers to assist in reliving symptoms of dryness.


Vaginismus is reflexive spasming and tightening of the pelvic floor muscles with any attempt at vaginal penetration.

This can create pain with penetrative sex, but also with pelvic exams or tampon use.

Vaginismus can develop even if you have previously experienced painfree sex.

Vaginismus often is the result of sexual trauma or previous traumatic experience with painful sex, but can also be related to feeling of shame around your sexuality.

Pelvic floor physical therapy helps women suffering from vaginismus to connect with their pelvic floor in a healthy way.

Mental health therapy will also help women suffering from vaginismus heal faster.


Do not underestimate your body's need to heal postpartum. It is very important you give yourself plenty of time and only choose to have sex when YOU are ready.

Your body has been through a lot and needs to recover.

Remember, it's never normal to have pain with sex. If you find yourself developing pain with sex postpartum, or have suffered from painful intercourse your entire life, make sure you make an appointment with a pelvic floor physical therapist today!

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