While healthcare professionals advise waiting four to six weeks following delivery to have sex, the question of when and how to reintroduce sex postpartum is still a big one for couples. After nine months of pregnancy and subsequently caring for a newborn, “not many couples know much about the changes, physical and psychological, that could complicate their sex lives post-pregnancy,” affirms relationship psychologist Galena Rhoades, Ph.D.
Intimacy, however, can be a time to reconnect with one another and build a stronger bond during a vulnerable time. But sex after pregnancy isn’t the same for everyone; so it’s vital to learn how childbirth can affect your body before rekindling romance postpartum.
It’s not unusual for women to undergo changes in their mood and energy following childbirth as their bodies are working around the clock to adjust to fluctuating hormones and sleep deprivation. In fact, exhaustion is a familiar source of irritability and mood swings for many, which is why 80% of women experience the “baby blues” — a brief period of mild feelings of sadness or aggravation after giving birth. But when the blues last longer than a week or two, it may be an indication of postpartum depression — a form of depression that can occur after childbirth.
In addition to counseling and therapy, treatment for PPD often includes antidepressants. However, some antidepressants, namely selective serotonin reuptake inhibitors (SSRIs), can have side effects like sexual dysfunction or low libido. Fortunately, a different class of antidepressants known as norepinephrine-dopamine reuptake inhibitors (NDRIs), like Wellbutrin, can alleviate symptoms of depression without impacting your sex drive. “Wellbutrin has been shown to have no sexual side effects due to its mechanism of action,” maintains Dr. Chad Collom, a family psychiatric mental health nurse practitioner. In fact, “Wellbutrin can actually increase one’s sex drive.”
With all the hormonal changes that the female body undergoes during and after pregnancy, paired with weight gain, stretch marks, and thinning hair, it’s not uncommon for women to experience low self-esteem even though these changes are entirely normal. Although, negative body image has been shown to lead to sexual avoidance, likely caused by feelings of discomfort in women about being undressed by their sexual partner. But a positive body image can help you feel confident and comfortable in your new skin as a mom and can avoid future resentment from feelings of disconnect.
Fortunately, there are subtle efforts that can minimize the effects of postpartum body dissatisfaction and help women feel better from the inside out. For instance, women may buy products that reflect their needs as a new mom, like shampoos that counteract hair loss while adopting new lifestyle changes like starting a new vitamin regimen and drinking more water.
Aside from acting as a metabolism booster, water keeps the body well-hydrated, including our largest organ — our skin. When skin is well-hydrated, it becomes more resilient and thus less susceptible to tears caused by stretch marks. Water, coupled with skin-boosting vitamins like flaxseed and omega-3 rich fish oils, can help skin bounce back even better than before pregnancy.
Keeping with changes, you may notice changes down under as well depending a lot on your birth experience and hormones. When a woman gives birth, her estrogen and progesterone levels decrease, which can lead to vaginal inflammation, soreness, dryness, and itching. If a woman chooses to breastfeed, her estrogen levels will remain low so that her body can continue to produce milk, and therefore extend the duration of any vaginal dryness.
Vaginal discomfort can pose a challenge for sex, but there are several simple solutions. Using lubrication during sex is always a good idea to minimize friction, and women can use an estrogen cream to help produce their own lubrication. Women can also seek pain relief by soaking in a warm bath but should avoid bubble bath soaps and other products like douches and feminine hygiene sprays which can irritate an already sensitive vaginal region. Pelvic physical therapy is also a good idea to strengthen your pelvic floor and reduce any pain in the pelvis and bladder post-baby.
Although intimacy and sex may be different after pregnancy, it doesn’t mean it has to be any less beautiful. It’s important for women to hone in on the messages their body is sending and allow time to heal both physically and emotionally. Being open with your partner about your concerns will strengthen your connection by fostering trust and respect. From there, you and your partner will adjust to new ways of expressing affection.