After being purlins all our life changesWe have a baby who takes up all our time, and we find that we only have time for... take care of the. His care does not leave us a moment to think about anything and our mood is not going through its best time, so it seems almost impossible to consider the return to our previous routine, but after a while we have to gradually return to our normal life and that includes restart intimate relationships with our partner ...
When is the best time to restart sexual relations?
Suddenly all kinds of doubts assail us:When Will we resume sexual relations? Is there a specific date? How do I know if I'm... ready?
Although traditionally it is spoken of the “quarantineRegarding the weeks of maternity leave that the mother is considered obligated to take for her recovery, most experts recommend waiting at least a month or until we stop staining. But if something is important, it is that the mother is recovered after childbirth And be patient, because it certainly won't be easy; you'll notice discomfort in the vulvar area, especially if you've had stitches. In this case, you'll feel tightness in the scar; it's also common to... dryness Vaginal bleeding that occurs postpartum (even if you had a cesarean section) and is more noticeable if you give Breastfeeding.
Why does it happen? Because the prolactin It is a hormone that ensures milk secretion and prevents ovulation. Prolactin levels remain very high at this time, producing a chain reaction that hinders the synthesis of other hormones, leading to vaginal dryness and less sexual appetiteIn this way, prolactin prioritizes the eating of the newborn and can affect the milk productionProlactin prioritizes eating of the newborn: if there is no egg available there can be no pregnancy and, if there is a lack of desire, there may be fewer relations and therefore a lower probability of a new pregnancy.
If all this weren't enough, you'll notice that the breasts will be full of milkThis can cause discomfort and even expel some of the milk during intercourse. And when we finally find the right moment, the baby may have finished its nap or be ravenously hungry, so we'll probably have to postpone it more than once. Some helpful strategies include using water-based lubricants, make a extraction or prior administration to relieve the breast engorgement, to choose comfortable positions and dedicate time to the preliminary to promote lubrication.
Breastfeeding as a contraceptive method (LAM)
Breastfeeding can act as natural contraceptive method thanks to prolactin. This method is known as APPLE (Lactational amenorrhea method). However, to be relatively reliable, it must meet certain criteria. strict requirements:
- Exclusive: without formula or other food or liquids.
- AskedFrequent feedings day and night. Typically, no more than 4 hours pass during the day and no more than 6 hours at night between feedings.
- The stimulus should be from baby at breast (not just breast pumps), since this helps maintain prolactin levels longer.
Even if all criteria are met, MELA is only one option temporaryIts practical use is usually limited to the first months exclusive breastfeeding and loses effectiveness as soon as the menstruation or it begins supplementary feedingFurthermore, it is impossible to know for sure when it will happen. primera ovulation after childbirth, therefore It is recommended to add an additional contraceptive method if a new pregnancy is not desired.
How can I avoid another pregnancy?
But when we finally get to have sex again regular formDoubts assail us: Can I get pregnant again? What method? contraceptive Is it compatible with breastfeeding? Which one is best? There are different options, although not all contraceptives are equally safe:
- Breastfeeding as a contraceptiveWe've already discussed the properties of prolactin. If breastfeeding is exclusive, it already demands the principle It will prevent ovulation. It may work for a while, but it won't prevent ovulation indefinitely, so the risk The risk of becoming pregnant again is high. Furthermore, we will never know when ovulation occurs, as there is no clear symptom. As a practical guideline, if breastfeeding ceases to be exclusive, if feedings become less frequent, or if menstruation returns, the LAM (Lactational Amenorrhea Method) is no longer considered valid. validTherefore, if you are not looking for a new pregnancyIt is recommended to add another method.
- Barrier methods: fundamentally the condom. Its easy When used, they produce no side effects and do not require prior consultation, so they are often the first option, at least until a longer-term method is decided. Other barrier methods, such as diaphragm o cervical capThey are recommended starting from 6 weeks Postpartum to allow time for the reproductive tract to recover, and if you were already using them before, you may need them new size adjustmentSpermicides alone are less effectiveTherefore, they are not recommended as a sole method.
- Natural methods: it is needed training, and prior to being able to use them. If you haven't practiced observing the cervical mucus and other signs, it's difficult to distinguish them now, and the postpartum period disrupts regularity. Even with normal cycles, there are false positives or negatives, so the postpartum period is not the best time to start using them if high fertility is desired. to maximise security and your enjoyment..
- Intrauterine device (IUD): it must be inserted by a expertIt's a medium- to long-term method. IUDs exist. coppermade (non-hormonal) and IUD with levonorgestrel (hormonal), both Compatible with breastfeeding. Its placement can be done at different times: immediately after childbirth (more likely to expulsion), or preferably from the 6 weekswhen the uterus has returned to its normal size. Insertion and withdrawal are Quick and require no special preparation. The duration depends on the model and can vary. years, with the advantage that it can be removed when you want to try to get pregnant.
- Hormonal methods: contraceptives based on progestogens are safe during breastfeeding They are beneficial for both the baby and the mother and do not decrease milk production. different pathways: daily tablet (minipill), subcutaneous implant y injection Periodic. The start date may vary depending on the method and clinical judgment; during the first 6 weeks Postpartum, priority is usually given to barrierand then assess the most suitable progestin-only hormonal method. Those combined with estrogen (combined pill, patch o ringThey are not recommended at the start of breastfeeding because they can reducir the amount of milk; these, if assessed, are usually postponed and always under professional supervision.
- Definitive methodsThese methods consist of surgical interventions, in men or women, to achieve permanent contraception. In women, the tubal ligation It can also be performed in the context of a cesarean section, with prior consent. In men, the vasectomy It's an option with a quick recovery. They are only appropriate if there is a decision firm of not having any more offspring.
It's important that you choose the method that best suits your needs, the one that is most convenient for you. comfortable and that allows you to plan your next pregnancy when you and your partner prefer. If you have any doubts, consult your doctor. gynecologist o matrona to define the best time to start and detect possible individual contraindications.
Emergency contraception while breastfeeding
Sometimes, it may be necessary to resort to a emergency method (e.g., condom breakage). Options based on levonorgestrel They are compatible with breastfeeding. Some formulations may require simple measures such as giving a takes just before and, in certain cases, space the next one out by a few hours depending on the data sheetIf another molecule is being considered, always follow your healthcare professional's instructions and consult up-to-date sources of information. compatibility with breastfeeding. In any case, as much as before The more emergency contraception is taken, the greater its efficacy.
Quick FAQ
- Can I use contraceptive patches? The patches are usually combined (with estrogen) and is avoid during breastfeeding due to their potential impact on milk production. If considered later, it should be with professional evaluation.
- When can I use a diaphragm or cap? After a few 6 weeks And if you used them previously, it's advisable reset the size.
- When does fertility return? You can return before of the first menstruation. Therefore, even with amenorrhea, it is advisable to use an additional method if you do not wish to become pregnant.
Practical tips for resuming sexuality after childbirth
- Time and communicationValidate your feelings and talk to your partner. Reconnecting gradually helps you regain the intimacy. privacy.
- Lubrication: uses lubricants water-based or silicone-based to relieve typical vaginal dryness caused by prolactin.
- Breast comfortA previous intake or extraction reduces the tension and possible milk leaks.
- PosturesChoose positions with control of movement and without abdominal or perineal pressure if there were stitches.
- Warning signs: if there is pain Persistent bleeding, heavy bleeding, foul odor, or fever; consult a doctor to rule out complications.
It is also useful to remember that, according to observational studies, many women regain their sexual desire between the ages of 10 and 11. first weeks and the first months postpartum; however, that rhythm is variable And there's no single schedule. The important thing is to prioritize your people's wellbeing and opt for methods payments and compatible with your breastfeeding and reproductive goals.
La uncertainty Regarding the return of ovulation postpartum, the lack of knowledge about the actual effectiveness of LAM outside of its strict requirements, and the widespread belief that amenorrhea implies infertility They explain why specialists recommend choosing an additional method. Among the alternatives, the condom It stands out for its safety and protection against STDs, the IUD (copper or hormonal) offers a solution Long duration and contraceptives progestogen only (Minipill, implant, injection) are compatible with breastfeeding. Avoid estrogen in the early stages and consult the window more suitable to start each method. And if an unforeseen event occurs, contraception of emergency It is an additional tool that can be used during this period with the Precautions described.
