Let’s Talk About Sex, (After) Baby
Having sex after giving birth can be low on the priority list for parents, especially when physical healing and lack of sleep loom large on the horizon. However, re-establishing intimacy, maintaining sexual connection with your partner, and nurturing your evolving relationship are common concerns for many new parents.
Hormones play a big role when it comes to postpartum sex, especially since it can take a few weeks for their levels to return to your normal. Sometimes it may take longer depending on whether any postpartum conditions are affecting you. Understanding the role of hormones in, and impact on, women’s bodies is important for navigating those transitional weeks and months with compassion and patience—both for you and your partner.
Sex after birth: Blame it on the hormones?
Women’s bodies are composed of a variety of hormones that behave and affect us differently at different times.
Estrogen is one of the body’s main sex hormones. It’s responsible for the secondary sex characteristics like breast development and cervical fluid, and it enhances sex drive. Low estrogen levels can cause decreased vaginal lubrication and therefore painful sex.
During pregnancy, estrogen levels are quite high but they drastically drop following birth and may continue to be low during breastfeeding. Although it may not be worthwhile to test your levels until your period returns, if you find that your sex drive has yet to rebound once you start menstruating again, it’s best to have your estrogen tested around day three of your cycle.
Home help: You can support healthy estrogen production in your body by including phytoestrogen-rich foods in your diet like flax seeds and soy, and other foods that are high in the phytochemical resveratrol such as red grapes, cranberries, blueberries, and nuts like pistachios, walnuts, and peanuts.
The scoop on soy
While many cultures eat large amounts of soy, there are some things to consider before serving it up. Believe it or not, soy is a common food sensitivity, so if you aren’t in the habit of including soy in your daily diet, introduce it slowly to ensure you don’t encounter any unwanted digestive symptoms. And while there is some concern about soy’s ability to compete with the body’s natural estrogen production and evidence that too much soy may even stop menstrual periods, maintaining a balanced and varied diet that includes small amounts of soy shouldn’t be of concern. Choose only organic soy to ensure you’re getting all the good stuff without the worries of sneaky pesticides.
Progesterone is the body’s other main sex hormone and estrogen’s counterpart. Your body needs to ovulate to produce it and it’s responsible for mood, promoting a restful sleep, and sexual desire.
Like estrogen, progesterone levels are fairly high in pregnancy, and decrease after birth. Moreover, because periods may take months to return to your normal, ovulation is likely absent and therefore progesterone is not being produced in large or consistent amounts. Once your period returns, you can test it around seven days after ovulation.
The best way to support progesterone production in your body is to be mindful of your stress levels. During periods of extreme stress, your body may begin to produce the hormone cortisol, at the expense of other hormones like progesterone and testosterone.
Home help: A relative excess of estrogen may also contribute to lower progesterone levels. In this case it’s important to promote a healthy gut and frequent bowel movements to ensure that once estrogen has done its job, it leaves your system. It’s also important to limit any external sources of estrogen that can be found in plastics and foods heavily sprayed by pesticides (like strawberries). To keep your digestive system healthy and happy, have a steady supply of fibre- and probiotic-rich foods in your diet and stay well hydrated.
Testosterone, a predominantly male hormone, is also present in women, although in smaller amounts. It’s another hormone responsible for sexual desire and helps to thicken vaginal tissues.
Signs of low testosterone levels may present as reduced sexual desire and drive, fatigue and weakness, and sleep disturbances. Higher testosterone levels in women may present as male pattern hair growth appearing on the chin, upper arms and legs, or abdomen, male pattern hair loss around the scalp, acne, or infertility. Testosterone can be tested anytime after birth, and should measure free and total testosterone, sex hormone binding globulin, and DHEA-S.
Home help: You can support healthy testosterone production by getting plenty of sleep and rest, reducing stress, and engaging in exercises like resistance or high-intensity interval training. Under the supervision of a naturopathic doctor, herbs like Tribulus and red clover have shown to support testosterone, and studies find that zinc and magnesium have been successful in raising testosterone levels.
Thyroid hormones are secreted by your thyroid, and have a role in influencing your body’s metabolic functions. When these three hormones are in balance, they promote a regular menstrual cycle, fertility, stable weight, energy, and more.
Postpartum women are sometimes at risk of being diagnosed with thyroid disorders like postpartum thyroiditis which can present itself with initial symptoms of hyperthyroidism (overactive thyroid gland), which include insomnia, anxiety, fatigue, weight loss, and heat intolerance, followed by symptoms of hypothyroidism (underactive thyroid gland), which include anxiety, depression, fatigue, brain fog, hair loss, weight gain, cold intolerance, and constipation. Sexual issues can manifest in decreased lubrication and orgasm difficulty.
Thyroid hormones can be tested at any time, and may evaluate TSH, T4 and T3, thyroperoxidase antibodies, and thyroglobulin. Treatment for postpartum thyroiditis is dependent on your lab results and may involve medication prescribed by your doctor.
Cortisol, a stress hormone, follows a daily pattern where levels are typically highest 30 minutes after you wake and decline throughout the day, reaching the lowest point before bed. Though it gets a bad rap for being associated with stress, your body needs it to maintain blood pressure, blood sugar, and immune status.
When cortisol is released during times of stress, it can affect your body in various ways. Typically, the accumulation of small, daily stressors (lack of sleep, missing meals, work worries) has a negative impact on your health, including sexual response and especially arousal.
While there is potentially nothing better than bed and/or room sharing with your new bundle of joy (or older bundles!), bed sharing and co-sleeping can make spontaneous sex difficult, and the lack of sleep associated with middle of the night kicks to the solar plexus can add to the exhaustion that lowers any potential for sex. While the co-sleeping time is short, enjoy the coziness! Getting creative, making a love den in a spare room, or scheduling time for sex may help until then.
Home help: Easing common stress (as distinct from genuine postpartum depression) through the postpartum transition isn’t always easy, but simple things that can help include practicing deep breathing, mindfulness and meditation, spending time in nature, and being at least minimally active, especially outside. Try incorporating adaptogenic foods into your diet as these herbs are helpful for a variety of conditions that put stress on the body.
Oxytocin, known as the “cuddle hormone,” is responsible for those feelings of love and connection. It’s released with hugging, bonding, and after orgasm. In the postpartum, oxytocin is usually increased with mom and baby bonding (especially during breastfeeding).
Low oxytocin levels have been linked to postpartum depression, a common condition that occurs in many women in the month following the birth of their child. Other hormones like progesterone and cortisol also correlate with postpartum depression, so we don’t yet have an idea of what the true cause is.
With depression, there is a difficulty in experiencing pleasure—both from bonding with your child and/or that of sexual activity—and common symptoms like irritability and social withdrawal may affect your ability to grow and nurture intimate relationships. If you think you might be experiencing postpartum depression, know that you’re not alone, and that licensed health care providers can help you during this time.
Home Help: The best way to boost oxytocin is to partake in activities known to generate it. Getting a massage, cuddling with your children or a pet, having plenty of skin-to-skin contact (with baby and your partner), laughing with friends, or exercise, are all great ways to generate more of those good feelings!
When it comes to sex and intimacy, it’s important to be mindful of where your body is at and how it makes you feel. If you’re feeling ready for sex before your doctor or midwife gives you the all-clear, be sure to explore other ways to bond with your partner. Cuddling, foreplay, and sleeping together (without baby in the room) may be good options for the time being. If you’re still “not quite there”, communicating, staying engaged with one another, and having insight about what’s going on in your body will support you both through this exciting and challenging time!
To help speed up physical healing, be sure to check out these herbal remedies for after childbirth.