Understanding your changing body

Your body went through profound changes during the course of your pregnancy. Now that you baby has been born, you’ll continue to experience things that may be new or different.

Sex is one of those things. In a study published in the British Journal of Obstetrics and Gynaecology, 83 percent of female participants experienced sexual problems in the first three months after their first delivery. According to the study, only 15 percent of women who had sexual problems after childbirth discussed it with a healthcare professional.

Postpartum vaginal dryness is a common and natural condition. Many women find that this dryness makes sex uncomfortable or even painful. If you’re experiencing this condition, there are steps you can take to ease the discomfort from vaginal dryness.

Hormones and vaginal dryness

Estrogen and progesterone are produced mainly in your ovaries. They trigger puberty, including breast development and menstruation. They also cause the buildup of a lining in your uterus during your menstrual cycle. If a fertilized egg isn’t implanted in this lining, estrogen and progesterone levels drop, and the uterine lining is shed as your period.

Estrogen and progesterone levels soar while you’re pregnant. Instead of being discarded, the uterine lining develops into a placenta. The placenta also begins producing estrogen and progesterone. These hormones are crucial to the health and progression of your pregnancy and baby.

Six hormones orchestrate the functions of your reproductive system. They are:

  • estrogen
  • progesterone
  • testosterone
  • gonadotropin-releasing hormone
  • follicle-stimulating hormone
  • luteinizing hormone

Estrogen and progesterone levels decline dramatically after you give birth. In fact, hormone levels return to their pre-pregnancy levels within 24 hours after giving birth. Your body dials down estrogen further while you’re nursing because estrogen can interfere with milk production.

Estrogen is important to sexual arousal because it boosts the flow of blood to the genitals and increases vaginal lubrication. A lack of estrogen is responsible for many of the symptoms women have during menopause, including hot flashes, night sweats, and vaginal dryness.

Some women take an estrogen supplement to counter this. Others won’t want to take one because it increases the risk of cancer and other problems.

Postpartum thyroiditis

Postpartum vaginal dryness can also be caused by postpartum thyroiditis, an inflammation of the thyroid gland. Your thyroid produces hormones that are vital to various bodily functions, including metabolism. The thyroid may produce too many or not enough thyroid hormones when inflamed. Postpartum thyroiditis affects 5 to 10 percent of women, according to the American Thyroid Association.

Symptoms of postpartum thyroiditis may include:

  • shakiness
  • palpitations
  • irritability
  • difficulty sleeping
  • weight gain
  • fatigue
  • sensitivity to cold
  • depression
  • dry skin
  • vaginal dryness

The type of postpartum thyroiditis you have will determine your treatment. Beta-blockers may help reduce symptoms if your thyroid is overproducing hormones. Your doctor may recommend thyroid hormone replacement therapy if your thyroid isn’t producing enough hormones. Thyroid function returns to normal within 12 to 18 months for 80 percent of women.

What does all this do to your vagina?

The tissue of your vagina may also become thinner, less elastic, and more prone to injury. The vagina can become inflamed, which may cause burning and itching. Intercourse can be painful and may cause bleeding from the vagina.

These symptoms should disappear when you stop breastfeeding and your estrogen levels return to normal.

What you can do

You can have an enjoyable sex life, despite postpartum vaginal dryness. The following are tips for enhancing your experience:

  • Use a lubricant when you’re having sex. If your partner uses a condom, avoid petroleum-based lubricants, which can damage condoms.
  • Talk to your doctor about using an estrogen vaginal cream, like conjugated estrogens (Premarin) or estradiol (Estrace).
  • You may also want to try a vaginal moisturizer, which is applied every few days.
  • Drink water. Keep your body well hydrated.
  • Avoid douches and personal hygiene sprays, which can irritate sensitive vaginal tissues.
  • Talk with your partner about your concerns.
  • Increase foreplay and try different techniques and positions.

When to see the doctor

Talk with your doctor if symptoms persist, if your pain is intolerable, or if you’re concerned in any way. Other conditions such as infections, diabetes, and vaginismus (involuntary contractions) can also cause painful intercourse.