Intimacy and Your Pelvic Floor
Reclaiming your sexual energy and pleasure post-baby.
Do you experience pain while having sex? Are you avoiding being intimate since giving birth because you’re afraid it will hurt or feel different? Have you just been doing it to keep things steady in your marriage (but don’t really enjoy it)?
If you can relate to any of the above statements, I want you to know that you’re NOT ALONE!
Fact: The medical term for feeling this is actually dyspareunia
and its diagnosis often qualifies you for pelvic PT.
A leading cause of painful intercourse postpartum is pelvic floor spasm, a condition in which the muscles of the pelvic floor remain involuntarily contracted, making penetration uncomfortable or even impossible. According to a recent study conducted by PelvicCare, 1 in 3 women report pain during intercourse that actually worsened 2 or more years after delivering their last baby. This is a common side effect of childbirth and it often does not pass or go away on its own. But the good news is that it is very very treatable.
Here at RM, we are committed to disrupting fear and pain cycles that restrict women's lives and your ability to thrive. Sexual intimacy, pleasure, and vitality are essential components to thriving in your life and marriage. So, TMI is not a thing here—we are bringing these conversations forward, educating you about what you’re experiencing in your body, and providing effective tools to help you head back between the sheets and have fun…even if it’s just for 5 minutes before your kids wake up and crash the party!
Pelvic Floor Function 101, Sex + Tools To Get Your Groove Back:
Time is on your side, not your doctor’s. The 6 or 8 week postpartum check up is not your defining moment and is often misleading. Your body is totally not healed, though you may no longer need medical attention. And, as for being ready for exercise and sex at that exact moment, that’s just not true for the vast majority of women. The reality is, it takes some vulnerability to look at your body after you give birth. You’re going to discover at first, a body that looks and feels very different than before. So, take your time—this is your body, your timeline, and when you feel ready to share yourself with your partner again, then it’s the right time for you.
A Lesson in Anatomy + Recovery. Your pelvic floor muscles are a network of tissues, muscles, blood vessels, ligaments and tendons. Post-vaginal or cesarean birth, this well-calibrated network needs time to recover and a few tools to help come alive again. When these muscles become chronically tight or overactive—known as pelvic floor hypertonia—it can lead to persistent discomfort, difficulty with penetration, and even urinary urgency or constipation. This actually starts in other parts of your body—rolling out your feet, breathing and moving your ribcage, mobilizing your pelvis and back. When your body feels easeful, the pelvic floor muscles relax and move as well. When you are stressed and not breathing, the most common human response is to retain that tension in your pelvic floor, hips, back and jaw muscles.
Pelvic floor tension is one of the most common causes for pain. It can feel a little confusing to have a weak and tight pelvic floor, but that is how muscles operate. When they are tight, they can’t engage and become weak, so surrounding muscles begin to tighten and overcompensate. For instance, your groin muscles and hip flexors will begin gripping to create stability in your pelvis when your central core and low-back waist are collapsing. Breath, soft foam rolling, and strengthening your transversus abdominal muscles all have exponential benefits when it comes to feeling your pelvic floor release and regain pleasurable sensation.
Scar tissue adhesions from tearing along your perineum, a c-section or internal scarring that may not be visible to outside observation. Scar tissue sticks to things which creates asymmetry in the surrounding areas, most notably in the pelvic floor. When the pelvic floor can not glide and move, it gets really tight (like when you throw your back out and can’t stand up straight). This is why, penetration of any kind can feel excruciating—the muscles simply can’t relax and stretch the way they normally would. Scar tissue also leads to other pelvic dysfunction like incontinence, organ prolapse, and diastasis recti.
Your pelvic floor is part of a system. It’s important to understand that your body is a system and that your pelvic floor is part of it. When you have pain and pressure in your vaginal wall that makes penetrative sex painful you are most likely dealing with a combination of the above conditions. Good news is, when you start treating the whole system, all of the symptoms begin to improve together!
Where To Begin
A pelvic physical therapist (not OT) that is specialized in manual and visceral manipulation. I look particularly for PT’s who are trained in the Jean Barral Method. They should talk you through everything, listen to your concerns, and be in communication throughout the session so that any internal or external treatments are consented to and you know what is being worked on, released, and realigned.
Gentle postpartum recovery exercises that facilitate functional strengthening, but also integrate your emotional and mental health. For pelvic floor hypertonia and postpartum recovery, start with exercises that focus on releasing tension before strengthening, such as:
Diaphragmatic breathing to encourage relaxation of the pelvic muscles.
Pelvic tilts and bridges with a focus on slow, controlled movement.
Soft tissue release with a therapy ball or gentle foam rolling around the hips and lower back.
Mindful stretching to reduce tightness in the inner thighs and hip flexors.
When you feel happy and relaxed, sex becomes more interesting and your body will respond more readily to the idea of intimacy and pleasure. Start in Phase 1, Week 1 of the RM App and discover your energy and creativity in all parts of your body and being.
Be honest with yourself and your partner. Sexual intimacy is not solely defined by penetrative sex as one of my favorite clinical sexologists, Hani Avital, founder of Shelaah, shares in her work with women and couples. Sexual intimacy is about all of your sensual pleasure and senses being brought to life and stimulated together. Postpartum sexuality can become an awesome opportunity to awaken parts of your relationship that you never knew existed before.
Something To Remember
Sexuality evolves and matures decade over decade. Post-baby, you may feel exhausted and have zero libido or you may feel the opposite and want to jump on your partner the second you’re alone. All experiences and desires are normal and there is no right or wrong way to live into your sexuality—it will ebb and flow over a lifetime.
But living with pain, restricting in shame, and silently suffering are formulas for total self-implosion. Breathe and relax. Your body is an incredible entity that is capable of healing, is powerful and resilient. Addressing pelvic floor spasm and hypertonia through breath, movement, and targeted therapy can restore your sexual wellness and confidence. Maturing within yourself, as motherhood often brings, can lead to you becoming more self-possessed, self-aware, and embodied, while experiencing greater pleasure and orgasms than you ever did before having kids.
Get a mirror, take a look down there, and then let us know your questions. If you’re in need of a pelvic PT, send us a message and we’ll help you find one. Join our community and chat with other moms. Plus, it’s the month of love—what better time than to talk to your partner and let them know how you’re feeling.
Honesty has a way of smoothing the path to intimacy more than anything else.