Postpartum Low Desire: Physical Causes

Before I was a therapist, I was a midwife, so when a therapist friend recently asked me about postpartum low desire in women, I couldn’t resist digging in and blogging about it.

Low desire after the birth is a VERY common experience. You’re not alone. And your partner is not alone in their experience of this either, in part because there are few written resources and little social support for partners. With this short series of blog posts, I hope to start a conversation that can help therapists, mothers, and partners.

In this first post, I will address some of the causes, and give some idea of how you might begin to address them. My next will go more deeply into how to work with postpartum desire issues specifically in intimate interactions.

There are MANY reasons a woman might experience low desire postpartum; physical, emotional, and relational factors may entangle and overlap. Treating low postpartum desire often requires confronting the emotional and relational along with the physical.

This series will discuss each of these factors in turn, and give some insight into how to begin the process of reconnecting with your body, your self, and your relationship. First, let’s delve into some of the physical factors behind low postpartum desire, and start talking about how to address them.

–Hormone fluctuations are a major cause of postpartum low desire. For as long as 18 months after the birth of the baby, estrogen, progesterone, prolactin, and oxytocin (among others) are all undergoing a major shift. Usually this sorts itself out on its own, and desire gradually returns, although there certainly are non-hormonal causes that may still affect desire levels long after. If you are experiencing significantly reduced desire 12 months after the birth of the baby, you might benefit from a visit with your MD, who can help determine if there is a residual hormone imbalance or identify and treat other related issues.

–Anemia can be another culprit. Again, a visit to the doctor is in order.

–Depression or anxiety postpartum are common, have many causes and can go on for quite a long time. Both contribute to low desire. If you lack motivation and energy, have difficulty feeling connected to your baby, are excessively worried, have racing thoughts, a sense that something is wrong, or just feel sad for no reason, this is a reason for a trip to your MD. A therapist may be able to help too. Postpartum depression and postpartum anxiety, whether mild or severe, are likely to have both emotional and physical causes, so a double-team approach might be most helpful.

–Sleep deprivation can go on for years. Although nobody feels sexy when they desperately need a good night’s sleep, you and your partner might have vastly different responses to sleep deprivation. Some people are completely undone by sleep deprivation, while others are still able to function. Keeping this in mind can help you avoid unnecessary recriminations if you and your partner respond differently to this unavoidable stressor.

–Physical changes can have a profound effect on desire. You might have changes in sensation, including pain or discomfort, you didn’t used to experience. One very common postpartum symptom is vaginal dryness. This is a temporary result of hormone fluctuations and is not necessarily a sign of “not being into it”. It can usually be remedied by use of a high-quality intimate lubricant. If that doesn’t do it, or if you experience other kinds of pain, PLEASE talk to your physician right away and also discuss it with your partner. Too often, people hide their sex-related pain from their partners, hoping to save their feelings, but such a choice can ultimately do much worse damage, physical and emotional. In this case, a sex therapist can be a great resource, both for helping you resolve the issue and helping you have those difficult but necessary conversations with your partner.

All these factors can interact and overlap, reinforcing one another; they can also interact with and reinforce emotional and relational factors. Next week, I’ll delve into some of those emotional and psychological stressors that lead to postpartum low desire. In the meantime, check out my post When Sex Doesn’t Go As Planned for tips on adjusting to changes in your sex life with grace and openness.