Spilling the Tea on Breastfeeding and Your Pelvic Floor

During pregnancy, your estrogen levels increase significantly, nearly 30 times higher than normal. This surge in estrogen plays a vital role in your baby’s development and the development of your milk duct system. It is also responsible for the higher amounts of discharge and swelling of the vulvar tissue that you may experience. It’s fascinating, isn’t it?

However, immediately after giving birth, your estrogen levels drop. This decrease in estrogen allows prolactin to take over as the main player. Prolactin is essential for milk production. Throughout your breastfeeding journey, your prolactin levels remain high while estrogen levels remain low. You might be wondering how this relates to your pelvic floor.

Here are three ways low estrogen affects your pelvic floor health:

  1. General weakness and atrophy: Lower estrogen levels can contribute to thinning of the pelvic floor muscles, leading to general weakness. This can make the muscles less supportive than they were before pregnancy. If you’re returning to exercise postpartum, it’s important to reconnect with this area and focus on progressively strengthening the pelvic floor and core before engaging in higher impact activities.

  2. Vaginal dryness: Decreased estrogen levels can leave your pelvic floor feeling dry, like a desert. Vaginal dryness can make it uncomfortable to wear underwear and may even cause pain during intercourse.

  3. Lack of libido: Reduced estrogen can lower your overall sex drive. It’s not uncommon to experience a lack of interest in intercourse postpartum. Between the hormonal changes, lack of sleep, leaky breasts, and adjusting to a new body, it’s important to give yourself grace during this time.

While breastfeeding can affect your pelvic floor health, these effects are usually short-term. As you begin to wean your baby, your hormone levels will regulate. (Important note: starting your baby on solids is considered the start of weaning.) In the meantime, here are some things you can do to help your pelvic floor while breastfeeding:

  1. Moisture is key for vaginal dryness:
    -Use a water-soluble lubricant to decrease friction during intercourse. We recommend the brand Slippery Stuff for its good ingredients and affordability.
    -Consider using a topical moistening agent like V-magic, Vitamin E, and/or intimate rose enchanted rose balm.
    -Discuss topical estrogen cream with your physician or midwife, as it can provide lubrication and may help improve pain during intercourse.

  2. Schedule a session with a Pelvic Floor PT: Pelvic Floor Physical Therapists can help manage dyspareunia (painful intercourse), ensure you aren’t experiencing urinary incontinence, improve your ability to orgasm, and help you safely return to exercise postpartum.

  3.  Focus on nutrition: Here is a list of foods that can naturally increase estrogen levels:

    -Legumes (beans, lentils)
    -Soy and tofu
    -Garlic oil
    -Sesame seeds
    -Kale and sprouts
    -Dried fruits
    -Dark chocolate

Written by:

Dr. Britnie Hornsby

Dr. Britnie is a Pelvic Floor Physical Therapist and the owner of The Pelvic Docs. Dr. Britnie is passionate about helping moms feel their best during all stages of motherhood. When she isn’t helping other moms, she is taking care of her two active boys! To find out more about Dr. Britnie and The Pelvic Docs, visit www.thepelvicdocs.com or follow them on Instagram at The Pelvic Doc.

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