Dealing with super painful post-partum sex, aka vulvar vestibulodynia

December 7 | Guest post by Jane Hansen
Dildo Stop
Photo by Bob Pagani, used by CC license

As I walked to my car carrying my new box of wax dildos under one arm and my breast pump over my shoulder, I thought to myself: I simply must write share this — the less glamorous side of motherhood.

Conceiving my daughter was not an easy road for my partner and I, but after three frustrating years, many visits to fertility clinics that ultimately resulted in nothing, we found ourselves pregnant in the late Spring of 2009. In February of 2010 I had an adorable baby girl. Aside from the regular baby chaos, everything had gone extremely well with my pregnancy, her birth and the baby milestones that continue to come along. Except for one thing: sex. I can't have it.

I'm not talking about the new parent, "I can't have sex because I'm too exhausted/covered in pureed squash/tired of having another being crawl over me all the time" dilemma. I actually can't have sex because it hurts. A lot.

After a few prodding questions to girlfriends who had kids (and vaginal births) about just how "uncomfortable" or painful post baby sex should be, I was able to determine that my own experience was definitely not a standard case of post-pregnancy healing taking its time.

After a few prodding questions to girlfriends who had kids (and vaginal births) about just how "uncomfortable" or painful post baby sex should be, I was able to determine that my own experience was definitely not a standard case of post-pregnancy healing taking its time. So, off I went to see my doctor.

She was awesome — she listened to me, agreed it wasn't normal and did an internal exam. The OB/GYN she sent me to did the same, plus some tests and an ultrasound. Once the tests were in I went back to the office and they told me that they didn't know what was up, but that they thought it might be endometriosis (something I've never had any hint of having before) and that the best thing they could suggest was that I stop breastfeeding and go on the pill. That solution didn't work for me and I frankly strongly suspected it wasn't actually going to solve my problem.

So, for a few months, in frustration, I gave up. After another month or two, both I and my partner started getting pretty … well … frustrated. Repeated attempts at intercourse were seeing no improvement and I was convinced that the diagnosis of possible endometriosis was not getting at the actual problem.

After some further asking around, I decided to pop into my midwifery clinic to see if they had any advice. Luckily for me and all involved they did. After asking me some more detailed questions, they determined that the problem sounded bio-mechanical. They agreed that it was almost certainly not endometriosis and they suggested I make an appointment with a pelvic physiotherapist. Did you know such a thing existed? I sure didn't, but I'm here to tell you that they just might be your post-baby BFF.

Image from page 43 of "A treatise on the nature and treatment of seminal diseases, impotency, and other kindred affections : with practical directions for the management and removal of the cause producing them, together with hints to young men" (1848)
Photo by Internet Archive Book Images, used by CC license.

Before I get into what my awesome new pelvic physiotherapist is doing for me, and why exactly I was walking around town with a box of wax dildos under my arm, I'll get really personal with you here. When asked to describe my pain during intercourse attempts, it took me a while to really put it into words. The sensation, aside from just "Owww! Not good, stop it now!" was a bit of a barrier. It felt like there just wasn't any room for my partner to go once he got on his way in there. He would "hit a wall" as it were. A painful, nasty wall.

Other than during intercourse, I had no pain. At all — no discomfort. Nothing. Frankly, I often started to worry that the whole thing was in my head. What I've since learned is that my body was being triggered, due to some sensitive post-delivery nerves which cause the internal muscles of the vaginal wall to spasm, literally closing off my vagina and making penetration difficult/painful. Not in my head.

It turns out that the condition I have is called vulvar vestibulodynia (how's that for a mouthfull?), and it can manifest in many different ways and at different times for different women. A common time for it to occur is post vaginal birth. For some women the pain is all the time, for others it's just with intercourse (like me). For some there's also itching. For me: no itching.

The crazy thing about it, which is ultimately what compelled me to write this piece, is that many women go years (!) without being diagnosed properly. Often they see multiple medical practitioners before finding someone who can diagnose it, let alone treat it properly.

Image from page 125 of "Diseases of women. A clinical guide to their diagnosis and treatment" (1899)
Photo by Internet Archive Book Images

Similar to miscarriages and infertility, this seems to be an area of women's health that is kept pretty hush-hush and as a result very few people seem to know about it, health professionals included. But also like miscarriages and infertility, now that I've started talking about it with a few close friends I'm hearing tales of other women who suffered with the same thing. According to my physiotherapist most women take between 3 to 5 years to be properly diagnosed. That's 3 to 5 years of painful or no sex. Ugh.

So what am I doing now? Well I have to do daily exercises to learn to take control of my pelvic floor muscles and slowly start to teach them to relax and not spasm. It's honestly more than a little bit weird, but also kinda cool. And yes, some of those exercises involve the dildos, which in the pelvic rehab profession are called accommodators. And, like I said, it's kinda weird.

That said, I can not begin to tell you how liberating it was when I had my first physio appointment and the therapist listened to me, diagnosed me, and assured me that this was a treatable, not at all uncommon condition, and not all in my head. And, so while it is definitely a bit strange to spend an hour at 8am every second week doing pelvic floor exercises while hooked up to a bio-feedback machine, it is working. After that initial appointment, the simple knowledge that what I was experiencing was real and treatable was in and of itself a huge stress reliever for me.

I'm sharing my story with y'all here in the hopes that for some of you I can reduce that diagnosis time from 3-5 years to like 3-5 weeks. If you experience similar pain/discomfort with intercourse post-baby birthing or you have a friend who starts asking you subtle probing questions that hint at such a condition, high thee hence to a pelvic physiotherapist! If you don't have such a thing at least bring the condition's name to your doctor, midwife or suitable healthcare professional and ask if they can help point you to some resources.

  1. That was so refreshing and so informative all at once! I'm sorry you had to experience it, but thank you for being so open and educating women about the condition 🙂 Glad you are healing and getting back up on the horse..er..um…bad choice of words? LOL!
    Thanks!

    1 agrees
  2. Wow, I think I had that! Or something like that. It was at least 18 months after my son was born before I had pain-free sex, and another 6 months beyond that before it really got good again. I assumed that when they sewed up my perineal tears they sewed a little too far – it felt like the opening just wasn't big enough and it wouldn't stretch. It slowly slowly slowly got better and – not to be too graphic – my husband was very patient about gently stretching and massaging the skin around the scar tissue. I probably should have talked to my Midwife about it but I just didn't even think of it, it never even occured to me that it might be anything more than getting sewed up too tight. Thankyou for posting this!

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  3. Thank you for writing this and to offbeatmama for posting it! My babe is still gestating, but I feel like I've got so many post-delivery sex life questions. And, unlike every other pregnancy- and birth-related topic, there is very little good info out there. I can find 6,387 blogs devoted to breastfeeding and the emotional side of adjustment, but zilch about the physical parts of sexual adjustment. I realize that this post is about a particular condition that many readers will not experience, but it's good to have ANY dialogue about the physical side of post-birth sex!

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  4. I have the exact same thing. (But I haven't had kids, I've just had this since I'vd been having intercourse and it is NOT PLEASANT.) So it was so nice to read this and hear that I may not be crazy. I was wondering why they diagnosed you for vulvar vestibulodynia and not vaginismus? Do you happen to know the difference? I sort of assumed I had vaginismus.

    I'm also glad to hear there are potential treatments and that they don't involve drugs. I have yet to make my way to a doctor about this as I had assumed they would try to give me a bunch of drugs I did not want to take (like how you were recommended birth control pills) or tell me it was all in my head.

    So thanks a lot for this post! It made me more convinced I need to get to a doctor.

    • Mel: Get thee to a doctor. and if the doctor doesn't help, ask her for a referral. You have to stand up and make a stink, but this is fixable – i asked doctors for years until I FINALLY found the right referral.

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    • Here's the thing about doctors: if you say, "That treatment option is not acceptable to me," they'll usually try and find another option. And if they don't… it's new doctor time.

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  5. What was the reason behind the suggestion of quitting breast feeding and going on the pill? That part totally confused me. I know that breastfeeding contracts the uterus but with something like this, how was that a possible solution?

    Oh and I'm totally calling all dildos "accommodators" from now on, I love that.

    3 agree
    • sounds like that was the solution given for the possible diagnosis of endometriosis. hormonal birth control can lesson the symptoms of endo.

      1 agrees
  6. I was diagnosed with something similar years ago — vestibulitis, and was sent to a physical therapist. This was long before other folks had heard of this, and I was also supposed to apply some cream on some part of my inner labia. I don't know if it worked or not, but I still store tension in that part of my body, making sex incredibly painful. However, the pain is only around the rim, at entry, and once those muscles relax it is pleasurable again. I don't know what caused it or makes it persist, but I do know that now that I am 6 months pregnant I am certainly trying to think of ways to release those muscles so that natural childbirth isn't so painful.

    • i was diagnosed with vestibulitis before my first child was born. it had no effect on the birth for me. two kids, two easy fast deliveries. it did get pretty ragin after my second though, pain all the time not just during intercourse.

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    • I'm also planning an unmedicated birth, and I have vestibulitis. The compromise I've come to is that my midwife will be using topical anasthetic on my vulva. Apparently it's pretty common at my birth center! It's topical, so there's no affect on the baby. Might be worth looking into if you're concerned (which I completely empathize with!).

      1 agrees
  7. You're amazing! Thank you so much for sharing your story–so well-written, informative, and courageous. This piece is exactly why I return to this site again and again. Thank you.

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  8. thank you for writing this and for being so honest! there just isn't enough information out there for post-pregnancy and i love that this site is open about all the grimy aspects. thanks for posting this offbeatmama!

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  9. thankyou for writing this. it makes me feel so much better to know that im not the only person in the world who has felt the " riding a broom stick covered in sandpaper " feeling. its so hard to explain to people.. even family why im on med's, why i dont want to do it.. and why after nearly 7 years "other stuff" just isnt fun anymore. i feel reassured its not just me, all in my head, or my way of sabotageing a relationship that is otherwise perfect.

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  10. I have vulvarvestibulitis and was tested by a sex physical therapist using the "q tip" test, she also did bio-feedback and depended upoun my nurse practicioner who specializes in women's health to review her notes and confirm it was indeed true.
    I have no children and was actually told giving birth could cure the vulvarvestibulitis.

    I think many women have this problem and may not even be aware b/c…surprise, surprise there isn't a ton of research on it yet(or enough if you ask me)

    1 agrees
  11. This was really intense. And I think there are women like me who have never had non-painful sex (thanks to vaginismus).

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  12. Hey there,

    I just wanted to pipe in here to thank people for their comments. I was super nervous writing this and worried it would hit radio silence.

    Due to the (very wise) article length limit on OffBeatMama I didn't include further things that have been raised here, but did want to clarify.

    This condition (and others that are similar) is not uniquely a post-partum thing. It can happen to women who have never had intercourse. I've also heard from my physio and talking to women about it happening after 1 kid, then going away after the 2nd and things of that nature. Time, in some cases, does also seem to heal things. For me that wasn't an option, ie/ "wait and see". I wanted to know that there were things I could do to improve the situation, and the physio plus time seems to be working.

    Also, I don't want to freak people out too much. Of the say 6 friends I queried when this happened none of them had this condition, but 2 of them knew women who had (and in one case put me in touch with her). So it's not totally rampant or anything 🙂

    1 agrees
    • This was posted a little while ago, but I feel like this is exactly what I'm going through. I had my child 3 years ago, and my partner and I have probably had sex less than 10x since then. It's extremely painful for me, and always feels like a tear. I had an episiotomy, so I thought that could be it, but from what I have been reading, the pain isn't the same. When I read your blog, I instantly connected with EVERY word you were saying.

      So, if you don't mind, because I can't afford to see a doctor right now myself … My partner and I are not married, so I can't be on his health insurance. However, we live together … and he makes more money than the average household, so I can't get insurance through the state without petitioning him for child support. It's crazy and a long drawn out story. Would you be willing to share your exercises with me? If it's too personal, I understand. I just wanted to figure something out. Thank you so much.

  13. Thank you very much for posting this. I have something that might be similar, though I don't think it is the same, and it only came on with my pregnancy. Intercourse is uncomfortable or painful (more of a burning sensation) but it doesn't necessarily start out that way. I thought it might be some kind of overstimulation affecting areas that have increased sensitivity due to pregnancy. But, I've been so nervous about talking to a doctor about it (because every other pregnant intercourse story I've heard has been along the "it's great!" lines). After reading your story, and all the comments, I think I will speak to a doctor about it. Again, thanks.

    1 agrees
  14. I have the same thing ("wall inside")- sans baby/birth. It's called vaginismus… and given that we're on a LDR, I keep sending plastic dildos via mail back and forth so that when we see each other my guy and me can practice/desensitize me. 😛 Given how long it took me to find out what I had (several VERY bad ob/gyns unfortunately, who were clueless, suggested I just chill, that maybe I was a lesbian and/or a nasty operation that as I since have found out is bs- this is often not even taught in their manuals), I really wish this was taught more (sex manuals etc) and spoken/written about.

    PS: I have now actually read the other comments- I think it is important to remember that sex is not just p-in-v. I have had amazing sex with boyfriends. For the women who are thinking about treatment (you absolutely should!!!) here is a great website, advice from those (formerly) affected to those currently affected:
    http://www.vaginismus-awareness-network.org/

    1 agrees
  15. Wow! I never knew that could happen. I'm so glad you finally found someone who knew what the heck was going on and could help! Blessings to you and your hubby!

    I'll definitely keep an eye out for this after birth.

  16. I have vestibulitis and I have found that for me it is related to hormones. I had it *bad* when I was on the pill, still have it bad now that I'm pregnant – the only relief I got was when I went off the pill to try to get pregnant but wasn't pregnant yet. It doesn't sound like this is the issue of the author, but I wanted to put my experience out there for other women who are looking for a possible cause. Sounds like there are so many different things that can trigger this – I am really, really glad to hear that I'm not alone in this, though.

    1 agrees
  17. I was officially diagnosed with provoked vestibulodynia yesterday. I'm 11.5 months post-partum. It's so nice to hear you and so many commenters say, "me too."

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