Episode 20: Why Sex Hurts Postpartum — And What You Can Do About It

In this episode, Becky and Jessica tackle one of the most requested (and under-discussed) topics in postpartum care: painful sex. Whether you're weeks, months, or even years postpartum, pain during intimacy is common — but not something you have to just live with. They break down the most common causes, what it actually feels like, and what you can do about it. 

🧠 Your brain matters as much as your body Fear, stress, and feeling "touched out" all impact sex. You're not broken — you're exhausted, and that’s valid.  Sometimes, sex hurts because it’s the last thing you want. Lack of sleep, stress, and feeling disconnected can all tank libido.

🩹 Scar tissue should be assessed Pain from perineal or C-section scars is real — and often pinpointed, burning, or tight. PT can help reduce that stiffness and sensitivity.

💧 Estrogen takes a dive postpartum Whether you’re making milk or not, low estrogen means dry, irritated tissue. This can feel like sandpaper or tearing — and even tons of lube may not fix it (but still use it anyways!)

🧴 Topical estrogen is effective — and safeTopical, low-dose vaginal estrogen is considered safe in lactation and we are BIG FANS!

🧘 Muscle guarding is very, very common Tension in the pelvic floor (and hips, glutes, adductors) can lead to that “hitting a wall” feeling. Your body may be protecting itself — for good reason.

🛑 C-section parents: this could still apply to you Cesarean births doesn’t always exempt you from pelvic floor issues. Scar tension and deep pain are real and treatable! 

🔁 It’s not linear — and it’s not forever Pain should improve over time. If it’s not, a pelvic floor PT can help untangle the why.

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