August 25, 2020

By Emeline Mugisha, M.S.N., M.P.H., R.N.

Pregnancy and childbirth bring many changes to women’s lives. Your sexual relationship, sexuality, and intimacy are all aspects that can shift dramatically after pregnancy. Specifically, moms may experience impaired ability to engage in or enjoy sexual intercourse and orgasm after having a baby. However, with time, effort, a bit of humor, and perhaps a provider-approved lubricant, it’s possible for you and your partner to rekindle the spark in your relationship!

Is it normal to have no sex drive after childbirth?

Yes. Postpartum sexual problems are common among women and include:

• sexual desire problems (hypoactive sexual desire disorder)
• sexual pain (including dyspareunia, or painful sex)
• sexual arousal problems
• vaginal dryness, tightness, or looseness
• bleeding or irritation after sex
• orgasmic problems

The estimated percentage of moms who experience the above problems during the postpartum period varies widely depending on the study population and research methods, but it is generally thought to be a widespread issue. One British study, for example, found that 83% of first-time moms experienced sexual problems in the first three months after delivery, and almost two-thirds still had problems at 6 months. Other studies imply a lower overall incidence rate, for example, about 4 in 10 women experience sexual issues during their lifetime.

In terms of onset, one study found that sex is less frequent towards the end of pregnancy, and for most moms, there is a slow return to pre-pregnancy sexual activity in the first year after birth. Another study found that the average time for resuming sex and birth control was six weeks postpartum, but nearly half of women reported sexual problems over the next year.

Why is my sex drive lower after childbirth?

“Libido” is a medical term that means “sex drive” and is used to describe an individual’s desire to engage in sexual activity. There are a number of factors that may contribute to a low libido after childbirth, many of which improve over time.

One key reason that your libido is lower after childbirth is that your hormones are at work! During this time, your body is focusing on healing itself and producing milk if you are breastfeeding. Hormonal changes include lowered estrogen levels, which drop immediately after birth. Decreased estrogen leads to menopausal symptoms for a few weeks, including reduced libido and vaginal dryness.

Understandably, the exhaustion of motherhood also contributes to a reduced sex drive. Carrying your baby for nine months, delivering your baby, as well as timely feeding and lack of sleep can be exhausting both mentally and physically, leaving a lower desire for intimacy.

How women feel about themselves and the changes taking place in their life may also affect libido. Sometimes, new moms feel conscious about their body image after giving birth, including weight gained. Another familiar feeling that may change sex life is fear of another pregnancy. Discussing birth control options with your partner and provider may help ease this concern.
Additional factors that may impact sex drive after birth include:

• Underlying medical disorders
• Postpartum depression
• Breastfeeding (lowers estrogen levels)
• Painful sex

Related: What to do about painful sex after childbirth

While research about the influence of mode of delivery on postpartum sexual function is still growing, the evidence suggests that there is no significant difference in outcomes between women who deliver vaginally and women with an elective cesarean section.

How can I increase my sex drive after childbirth?

Your hormones are usually re-setting to pre-pregnancy levels during the first six weeks postpartum. It’s essential to consult your gynecologist before resuming sexual activity to ensure overall wellness and the return of your reproductive organs to their pre-pregnancy state.

Additionally, there are several non-sexual physical intimacy options to increase your sex drive, including cuddling, kissing, and massage. Most importantly, partners can ease the process of restoring intimacy and affection by staying kind and gentle to each other and themselves. Hang in there, be patient, and with time your sex drive will eventually return.

What can I do if my sex drive doesn’t come back?

A lowered libido for at least six months after birth may indicate hypoactive sexual desire disorder (HSDD). HSDD is a reduced sex drive due to absent or decreased spontaneous desire, sexual desire in response to erotic cues or stimulation, or ability to maintain passion or interest through sexual activity, with associated distress.

If sexual problems don’t go away, it’s advisable to consult your medical provider. Your provider will assess your overall concerns and offer appropriate interventions, such as brief counseling. If indicated, they may refer you to a sex therapist for psychotherapy. Your sex therapist will determine the proper type of therapy needed for you, or you and your partner.

Sex therapy is a standard treatment for HSDD. It focuses on adjusting thoughts, beliefs, behaviors, emotions, and relationship communication that interfere with your sex drive. While limited studies are available that assess sex therapy’s effectiveness, research indicates that mindfulness-based cognitive therapy is effective in treating HSDD.

Mindfulness-based cognitive therapy is a type of psychotherapy that incorporates practices such as meditation. When used to treat sexual problems, the goal is to encourage you to connect and engage with your sexuality by learning and practicing a variety of mindfulness exercises. These exercises help improve your awareness of the present, acceptance, and self-compassion. Therapy sessions also include education about female sexuality and sexual function.

Sources:

American College of Obstetricians and Gynecologists. (2020). Your sexual health. Retrieved from https://www.acog.org/patient-resources/faqs/womens-health/your-sexual-health

Barrett, G., Pendry, E., Peacock, J., Victor, C., Thakar, R., and Manyonda, I. (2000). Women’s sexual health after childbirth. BJOG: An International Journal of Obstetrics & Gynaecology, 107(2), 186-195. https://doi.org/10.1111/j.1471-0528.2000.tb11689.xs

Eid, M., Sayed, A., Abdel-Rehim, Z., and Mostafa, T. (2015). Impact of the mode of delivery on female sexual function after childbirth. International Journal of Impotence Research 27, 118–120. https://doi.org/10.1038/ijir.2015.2

Goldstein, I., Kim, N. N., Clayton, A. H., DeRogatis, L. R., Giraldi, A., Parish, S. J., Pfaus, J., Simon, J. A., Kingsberg, S. A., Meston, C., Stahl, S. M., Wallen, K., and Worsley, R. (2017). Hypoactive sexual desire disorder: International Society for the Study of Women’s Sexual Health (ISSWSH) expert consensus panel review. Mayo Clinic Proceedings, 92(1), 114–128. https://doi.org/10.1016/j.mayocp.2016.09.018

Hughes, H. (2008). Management of postpartum loss of libido. The Journal of Family Health Care, 18(4), 123–125. https://www.jfhc.co.uk/management-of-postpartum-loss-of-libido

Sayasneh, A., and Pandeva, I. (2010). Postpartum sexual dysfunction: A literature review of risk factors and role of mode of delivery. British Journal of Medical Practitioners, 3(2), 316. https://www.bjmp.org/content/postpartum-sexual-dysfunction-literature-review-risk-factors-and-role-mode-delivery



Emeline Mugisha, M.S.N., M.P.H., R.N. - Emeline Mugisha is an award-winning, master's-prepared nurse with over a decade of experience in community/public health and clinical health services at the field and management levels. She has co-authored two professional manuscripts in Women's Health Issues and the Journal of Midwifery and Women's Health. She has an M.S. in Public Health Nursing and an M.P.H. from Johns Hopkins University.