How Pregnancy and Birth Affect Your Sex Life — and How Pelvic Floor PT Helps

Written By Chelsea Speegle

How Birth Changes Your Pelvic Floor

During delivery, the pelvic girdle goes through a remarkable series of movements to allow your baby to descend from the abdomen and exit through the birth canal.

First, the top of the pelvis and sacrum move outward — a motion called counternutation — to create space for the baby's head to enter the upper pelvic region. Once the baby's head reaches the pelvic floor muscles, the bones shift in the opposite direction (nutation) to open the lower pelvis for delivery.

Why These Changes Can Cause Pain With Sex

After this series of movements, the pelvic bones don't always settle back into a balanced position. This creates tension and pulling on the pelvic floor muscles. If tearing occurred during delivery, the resulting scar tissue adds additional tightness and restriction to the muscles.

These changes can directly impact sexual health, causing pain with initial penetration, deep penetration, or both. Some people also experience decreased libido due to ongoing pain and discomfort. Cesarean births are no exception — scar tissue from the incision can contribute to pain with deep penetration as well.

Sexual Dysfunction During Pregnancy

Pelvic floor issues affecting sex aren't limited to the postpartum period. During pregnancy, hormonal changes reduce stability in the pelvic girdle, causing the pelvic floor muscles to work harder to compensate. This increased demand can lead to pelvic floor tension and discomfort that affects intimacy even before delivery.

How Pelvic Floor Physical Therapy Addresses Sexual Dysfunction

A pelvic floor physical therapist can identify the specific driver behind your sexual dysfunction — whether it's muscle tension, scar tissue, pelvic girdle alignment, or a combination of factors. Treatment approaches include:

  • Manual pelvic floor releases to reduce muscle tension and improve tissue mobility

  • Scar tissue mobilization for perineal tears or cesarean incisions

  • Dry needling to address persistent trigger points in the pelvic floor

  • Stability exercises for the glutes and core to reduce compensatory pelvic floor tension during pregnancy

  • Perineal preparation techniques before birth to reduce tearing risk and minimize scar tissue formation

  • Education and home exercises to support ongoing recovery

Pelvic Floor PT for Sexual Health in Denver

Whether you're pregnant, newly postpartum, or years out from delivery, it's never too late to address pelvic floor dysfunction that's affecting your sexual health. At Pelvic Symphony PT in Greenwood Village, Dr. Chelsea Speegle, PT, DPT, PCES provides expert, individualized care for pregnancy-related and postpartum sexual dysfunction. Schedule your evaluation today.

Chelsea Speegle

Dr. Chelsea Speegle founded Pelvic Symphony PT with a simple belief: the body works like a symphony. Every muscle, joint, and system plays its own part, and when they work together, everything functions the way it should. When something is off, her job is to find which instrument is out of tune.

Chelsea earned her Doctorate in Physical Therapy from Loma Linda University in 2017 and began her career in orthopedics, where she quickly recognized how often pelvic floor dysfunction was connected to the conditions she was treating. That connection sparked a focus that has shaped her career ever since.

She has completed extensive advanced training in pelvic health through Herman and Wallace from Level 1 through capstone courses, including pelvic rehabilitation for athletes. Chelsea holds certifications in Pregnancy and Postpartum Corrective Exercise, trigger point dry needling (Levels 1 and 2), and pelvic floor dry needling. She has received specialized training in men's pelvic health, including male pelvic pain and erectile dysfunction, through Integrated Pelvic Care. She is currently expanding her expertise in low pressure fitness through the teachings of Becky Keller.

Chelsea takes an individualized, whole-body approach with every patient. Rather than treating symptoms in isolation, she assesses posture, breathing, movement, and pelvic floor function to identify what's actually driving the problem. Her goal is to restore confidence and quality of life for every person who walks through the door.

When she's not in the clinic, Chelsea enjoys long distance running, snowboarding, reading, playing the piano and cello, and spending time with her husband, two boys, and their dog and cat.

Doctor of Physical Therapy | Pelvic Health Certified | Pregnancy and Postpartum Corrective Exercise Specialist | Trigger Point Dry Needling Certified | Pelvic Floor Dry Needling | Low Pressure Fitness level 1 and 2

https://www.pelvicsymphonypt.com
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