Getting your Mojo back: #3 When postnatal sex is just a bit flat

What if you are having sex, confident there’s no medical issue, but its just not really ‘doing’ it for you?  I’ve heard mums say postnatal sex is flat,  “a bit boring really”, or  “sore and uncomfortable”, or “not very satisfying”.

I have 3 suggestions to help you shift from here back to a place of “OK! I’m back! & I can get more sexy and heat up a bit from here by myself”

1. Are you flexible enough?

Pelvic Health physiotherapists assess and treat antenatal and postnatal pelvic girdle pain (PGP) and back problems.  You need flexibility in the spine, pelvis, and hips for  comfortable  sex.  I’m convinced that it is no coincidence that the Karma Sutra looks like advanced yoga!

The problem is that you can go stiff in your back and hip joints quietly, with no pain at all, no apparent loss of ability to walk, sit, and carry.  However, we are not at our optimum function anymore.  With our bodies it is easy  not  to notice what you are missing.  Stiffness often doesn’t hurt.

In everyday life, clues that your back/hips might be stiff:

• you wake in the morning feeling morelike a granny than a gazelle and have to physically ‘get going’ for a few minutes or half an hour before you feel like yourself!
• after you have been sitting for a while your first few steps are painful or difficult
• you seem to be living with constant back ache
• when you try to pick up your pace to run or walk fast or do your sport, you get backache or a proper pain
• and/or your legs feel really heavy, like you are walking through thick treacle
• you realise that don’t really properly stand up straight anymore

With sex this manifests as:

• a sense that you can’t let go and fully relax,
• you can’t take your partners weight onto you,
• you can’t get comfortable or
• your can’t get close enough (which then means you are not getting enough external stimulation of the clitoris, making reaching an orgasm dependent on penetration alone – not enough for most women)

If you think this might be a problem for you try this:

• spend a week or two focusing on stretches for your lower back, inner thighs & hips
• if you had PGP during pregnancy and it is still niggling, go back to your physiotherapy team and ask for a postnatal review and assessment of your spine
• if you think that your delivery might have triggered a back or hip problem ask your GP to refer you for a physiotherapy assessment.   We tend to focus on trauma to perineum (the soft area) but did you have to to get into some awkward positions? Did you have to put your legs into stirrups at some point? Did you struggle to walk properly for a few days? Even with a caesarean there can be hidden trauma, possibly from being unable to feel your lower half properly yet trying to move about, let alone sleeping on a hospital bed for a night or two!

2.  Do your pelvic floor muscles need some attention?

Women don’t have that many nerve endings inside the vagina.  Inside, we feel ‘pressure’ and ‘deep touch’ more than light sensations.  The sexual pleasure we feel comes from the rubbing and build up of friction against the vaginal walls.  The vaginal walls at the base and the sides are layered with the pelvic floor muscles.

Clues that lack of pelvic floor tone might be a problem for you are:

• it just feels a bit dull and boring inside during sex
• you want to try to grip your partner but nothing happens
• you feel there is too much room inside (you might also notice this when using tampons)

If you think WEAK pelvic floor muscles might be a problem for you:

• make pelvic floor muscle training a focus for few weeks trying to make some impact on your muscle tone. 
• concentrate on good technique, especially making a difference between tensing AND releasing the muscles.  In the Pelvic Floor School there are some videos showing the muscles on my plastic mode.  Having a good visual picture of where they are really helps if their sensation is not great.
• You can  download a free pelvic floor muscle exercise booklet here which covers the basics.  If you are ready to move on to challenge the muscles to grow further try My favorite standing Pelvic Floor exercise.  It’s  a great brain/muscle teaser to do little and often through the day and really practical to fit in to a busy life.
• do ENOUGH exercises to make the muscle change and grow. Try our Pilates for your Pelvic Floor video for inspiration and to keep you focused.  
• consider using a muscle stimulation or biofeedback device, or vaginal weighted cones to enhance your standard pelvic floor exercises.

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If you think TIGHT pelvic floor muscles might be a problem for you: see #2 What to do when sex is painful

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3.  Can you tap back into your emotions or do you need some help?

 Be open and honest with your partner, and with yourself.  You may be loving being a mother but have you have lost your love of being a woman and a sexual partner?

If you’ve tried all the obvious things like making time (!), wining and dining each other and your usual pre-baby get in the mood tricks but you know it’s still not working for you – don’t forget that YOU could be the one (of many) experiencing a genuine, real, postnatal depression, anxiety or PTSD (post-traumatic stress disorder).

Childbirth is often considered to be a painful but yet exceptionally happy and wonderful moment of a woman’s life. But postnatal depression is a very real thing and affects too many mums mildly or severely. Isobel Harper, my friend and local Cambridge counsellor, reminded me that any difficult birth, or even a birth that is just not as expected, can leave a woman with a sense of failure. This can show up as not feeling bonded to your baby, but also in other ways such as not enjoying times with friends, losing your sense of self, or lack of libido. She describes 10 overlooked symptoms of depression and more about postnatal PTSD (post-traumatic stress disorder) on her website. 

Isobel recommends seeking help from a therapist with perinatal experience

• some hospitals have perinatal mental health teams
• some hospitals have midwives who offer a chance to talk through your birth in more detail. At the Rosie Maternity in Cambridge this service is called “Birth Afterthoughts”
• Petals is a national charity which supports parents who affected by trauma & loss.
• The Birth Trauma Association, The MASIC Foundation (supporting mothers with anal sphincter injuries) and Tommy’s are all wonderful charities with extensive information on their websites.

 

Please seek help from your GP or local physiotherapy team.  We are all here to help you.

Please do ask questions or share your story here. Your experience will help others too. #NoMoreMiserableMums