Anonymous on September 1, 2011

How do I get back to my old sexual self after having a baby?

I’m 41 and – after delivering a large baby (10 lbs., 12 oz.) – I’ve lost most of my muscle tone and sexual pleasure. My self-esteem and sexual confidence have also taken a hit. How do I restore my body and my self-esteem so that I can enjoy sex again?

answered by Annette Fuglsang Owens, MD, PhD on September 1, 2011

Thanks for sharing your questions. I’ll do my best to help.

First, you’re not alone. After giving birth, many women are discouraged because they don’t look or feel like they used to, “pre-baby.”

It’s no secret that women’s bodies change in pregnancy and through childbirth. Weight gain is one common “side effect”…and carrying a baby (especially a large baby) strains the muscles of the so-called pelvic floor. This group of muscles acts like a hammock that holds, cradles and “gives” as the fetus grow…so it’s common to lose tone and strength in this area.

Also, during delivery itself, the vagina may tear and need some time to heal. Related, many women have trouble controlling when they urinate…or it may be painful to urinate, or even just to sit. And if you’ve had a C-section, recovery can take even longer.

So it’s no surprise that you don’t recognize yourself. But take heart…there’s a lot you can do to shape up your body, and boost your self-image and sexual confidence.

First, allow yourself plenty of time. You’re probably busy caring for your infant, so don’t put excessive demands on yourself…instead, set realistic goals.

That said, you seem to be ready to take the first steps:

Consider dailyKegel exercises to re-train the muscles of your pelvic floor. In a nutshell, these exercises are as simple as tightening and relaxing the same muscles that you use to control when you urinate. Next time you urinate, notice which muscles you use to stop the flow of urine. Those are the same muscles you need to squeeze periodically (like when you’re watching TV or waiting for a red light).  

You can also get a device such as Gyneflex, which you insert into your vagina to help strengthen your pelvic floor muscles more effectively.
Additionally, you can ask your doctor to refer you to a pelvic floor specialist (usually a physical therapist) to teach you exercises and other techniques that help with muscle tone. Think of it as “rehab” for your pelvic floor.

And it may be necessary to get evaluated by a urogynecologist who can assess and treat any pelvic floor issues you may have.

Other options to strengthen your pelvic floor and your core muscles includePilates or yoga. These and similar options also help tone your whole body, and benefit your general health and well-being…which, in turn, can help you feel better about yourself overall (even before any obvious physical transformation has taken place).

Some forms of exercise and stretching (e.g., yoga), can also include elements of meditation and reflection that may further support your rediscovery of your “best self” within the context of your new role as a mother.  

Again, be patient. Allow yourself thechance to adjust. Give your body time to heal, and talk with your partnerabout what’s different…and ways to experience closeness, intimacy and sex in new ways.

I wish you happiness, and good luck in reclaiming your confidence and sexuality.

Related info:

Annette Fuglsang Owens, MD, PhD

Dr. Owens is an AASECT-certified sexuality counselor. Her areas of expertise include the medical aspects of human sexuality and sexual problems, as well as the impact of STDs ⎼ and other diseases, illnesses and disabilities ⎼ on sexuality. Dr. Owens was educated at the University of Copenhagen in Denmark.

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