Risk factors for postpartum and pregnancy-related sexual dysfunction include the following:
Trauma during childbirth: Cesarean delivery Cesarean Delivery Cesarean delivery is surgical delivery of a baby by incision through a woman’s abdomen and uterus. In the United States, up to 30% of deliveries are cesarean. Doctors use a cesarean delivery... read more
or delivery by forceps or vacuum extractor Operative Vaginal Delivery Operative vaginal delivery is delivery using a vacuum extractor or forceps. A vacuum extractor consists of a small cup made of a rubberlike material that is connected to a vacuum. It is inserted... read more , episiotomy Delivery of the baby 
, or tears in the area between the opening of the vagina and the anus (perineum) can make the area near the vagina's opening painful and decrease sexual interest and the ability to be aroused.Breastfeeding: Because estrogen levels are low during breastfeeding, the vagina may become dry, making sexual intercourse uncomfortable. Genitopelvic pain/penetration disorder Genitopelvic Pain/Penetration Disorder Genitopelvic pain/penetration disorder includes pain during sexual intercourse or other sexual activity that involves penetration and involuntary contraction of muscles around the opening of... read more may develop.
Psychologic and social stresses: Changes in family roles and relationships, sleep disruption, newborn health issues, and/or weight gain can increase stress.
Postpartum depression Postpartum Depression Postpartum depression is a feeling of extreme sadness and loss of interest in usual activities during the first few weeks or months after delivery. Women who have had depression previously are... read more : Being depressed can contribute to sexual dysfunction.
Intimate partner violence Domestic Violence Domestic violence is physical, sexual, or psychologic abuse between people who live together. It includes intimate partner violence, which refers to physical, sexual, or psychologic abuse by... read more : Pregnancy increases the risk of intimate partner violence (physical, psychologic, and sexual). Such violence in a relationship can undermine the woman's self-confidence, reduce her self-esteem, and cause depression, posttraumatic stress disorder, other psychologic disorders, and sexual dysfunction.
If sexual dysfunction, regardless of type, is present before pregnancy, sexual dysfunction after pregnancy is more likely.
Doctors recognize postpartum or pregnancy-related sexual dysfunction when a woman reports problems related to sexual intercourse during or shortly after pregnancy.
Treatment of postpartum and pregnancy-related sexual dysfunction is similar to treatment of other forms of female sexual dysfunction. For example, psychologic therapies and learning about how the woman's body changes during and after pregnancy may help, such as whether intercourse is safe during pregnancy and which positions may be more comfortable (for example, side by side). Doctors may suggest types of sexual activity other than vaginal intercourse, such as masturbation, massage, oral sex, foreplay, mutual caressing, kissing, fantasy, the use of sex toys, and cuddling.
