“My husband and I decided to go three months without having sex so I could breastfeed our baby. Breastfeeding bottomed out my estrogen levels so sex was extremely painful. When I talked to my OBGYN about it, he told me that my vagina looked like that of a 70-year-old woman and that the painful sex would only stop if I stopped breastfeeding. Because breastfeeding was important to us, we decided to do other things to be intimate for three months. The day after I stopped breastfeeding, sex was no longer painful. As a result, I thought my OB was right. Recently, I was told by pelvic floor therapists that I could have breastfed my baby and had pain-free sex too. I wish I had known that sooner.”
The mom who told me this was diagnosed with lactational atrophic vaginitis. The symptoms are vaginal dryness, itching, burning, irritation and painful sex and they can happen as a result of low estrogen that accompanies breastfeeding.
The picture below highlights a urethral caruncle which most women never know they have as it is asymptomatic, but it is mostly associated with low estrogen. I encourage you to know what is going on with your body so use a mirror to check and see if you have one especially if you are having painful sex and breastfeeding or if you are reading this post and are postmenopausal.
I recently attended a conference with physical therapists who have been treating the pelvic floor for decades. Although many recommendations were given, the top one for vaginal dryness and return to pain-free sex was a Replens suppository that is inserted into the vagina much like the nuvaring. As it does not contain estrogen, it doesn’t impact a mother’s milk supply. If you have tried Replens and are still having pain or dryness, please message or call me so we can talk about other options that may be better for you.