• Hormonal changes. Loss of the female hormone estrogen, which occurs temporarily in all women after giving birth, can cause the vaginal tissues to become thin and somewhat raw. This can lead to a burning sensation during or after sexual intercourse. Breastfeeding moms, in particular, can have low estrogen levels for months after the baby is born.


• Lack of lubrication. When estrogen levels are normal, sexual arousal leads to secretion of a lubricating liquid from the walls of the vagina; when they're low, less lubrication can lead to chafing and irritation. In addition, many women find their sex drive and arousal response to be diminished after having a baby, although it isn't clear whether this is due to exhaustion or hormonal changes.


• Episiotomy or laceration. Sometimes the site of an episiotomy or laceration remains tender for many weeks.


• Vaginismus. Spasms of the muscles around the opening of the vagina, called vaginismus, can occur as a painful reflex when penetration is attempted. Sometimes this condition develops as an unconscious reflex when the body expects pain and eventually becomes a self-perpetuating cycle of pain and spasm. Any cause of dyspareunia can lead to vaginismus.

• Communicate with your partner. To make sex the pleasure for you that it once was, the two of you will need to work together.
• Take it slow. Tolerating pain will not make it go away and can lead to vaginismus.


• Try a water-based lubricant, which you can buy off the shelf at your local drugstore.


• If the pain persists, talk to your practitioner. She might be able to recommend another approach that would be effective in your case.


• Try to keep the big picture in mind. Your body has accomplished an amazing feat--producing a whole little human--and it can take quite a while to get back to normal.

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