Post-Partum Hormones
Written by Matilda Wilkinson, Pelvic Health Physiotherapist, Pelvic Project Co-founder
Pregnancy is an incredible journey that significantly changes the body, biologically and psychologically. These changes are necessary to support fetal development and prepare for childbirth. However, they can also bring discomfort and, in some cases, ongoing symptoms that new mothers should not have to suffer with in silence. Understanding what is ‘normal’, what requires attention, and what treatment options are available can make all the difference in postnatal recovery.
One of the most common misconceptions is that issues such as urinary incontinence, vaginal discomfort, and pelvic pain are simply part of becoming a mother. These symptoms are common, but they are not ‘normal’. They are not something women should just “put up with.” There are effective treatments available, and support is at hand through pelvic health specialists which is commonly accessed at the 6 week post-natal check.
At Pelvic Project we believe women deserve access to information and specialist practitioner advice before this point. So here we discuss some of the common pelvic conditions that can arise during this post-natal period, along with practical advice for recovery. If you would like to discuss your symptoms further please book in for a 1:1 virtual consultation.
1. Vaginal Laxity and Weakness
During pregnancy and delivery, the pelvic floor muscles can stretch up to three times their normal length. Factors such as the size of the baby, the duration of labour, and whether interventions such as forceps or vacuum delivery were used can influence the degree of stretching. As a result, many women experience pelvic floor weakness, which can manifest in various ways:
Urinary incontinence: Leaking urine when coughing, sneezing, laughing, or exercising.
Pelvic organ prolapse: A feeling of heaviness or dragging in the pelvic area caused by weakened vaginal walls.
Reduced sensation during intercourse: A loss of muscle tone can contribute to decreased sexual sensation and discomfort.
Recovery Tips:
Start gentle pelvic floor exercises in the first few days after birth to promote blood flow and begin muscle activation.
Avoid holding your breath when lifting objects, as this can increase pressure on the pelvic floor.
Book your 6-week post-natal check with a pelvic health physiotherapist who can carry out an internal assessment to check your pelvic floor function and guide you through a tailored rehabilitation plan.
2. Pelvic Girdle and Joint Pain
During pregnancy, the body produces hormones like relaxin to loosen ligaments in preparation for childbirth. While this is necessary, it can also lead to joint inflammation and pain, particularly in the pelvis and lower back. For some women, pain persists long after giving birth, leading to conditions such as:
Pelvic Girdle Pain (PGP): A condition that affects the joints in the pelvic area, causing pain and difficulty with movement.
Back pain: Often caused by postural changes and increased strain from carrying and feeding the baby.
Carpal Tunnel Syndrome: Numbness and tingling in the hands due to fluid retention and repetitive wrist movements.
Recovery Tips:
Strengthen the glutes and core muscles to provide support to the pelvis.
Use compression garments for added joint support while hormones stabilise.
Wrist splints and gentle hand exercises can help alleviate carpal tunnel symptoms.
Ice packs can reduce inflammation and ease joint pain.
3. Perineal Trauma and Scar Healing
Most vaginal births experience some form of perineal trauma during vaginal delivery, whether it be a minor graze, natural tear, or an episiotomy (surgical cut). Healing varies depending on the severity of the trauma, but discomfort is common in the weeks following birth.
Recovery Tips:
Keep the perineal area clean and dry to promote healing.
Use a perineal ice pack for 10–15 minutes at a time to reduce swelling.
Perform gentle pelvic floor exercises to promote circulation and tissue repair.
When passing urine use a perineal spray bottle can help keep the area clean and reduce stinging.
When opening bowels, constipation is common immediately post birth, remain hydrated, avoid straining (to reduce pressure on the perineum) and instead ‘blow to go’ via deep breathing.
For those experiencing prolonged discomfort or pain during intercourse, perineal massage, guided by a pelvic health specialist, and the use of a high-quality vaginal moisturiser, such as YES VM, can improve tissue elasticity and reduce sensitivity.
4. Hormonal Changes and Their Effects
Hormonal fluctuations are a natural part of the postpartum period. Oestrogen and progesterone drop dramatically after birth, while prolactin levels rise to support breastfeeding. These hormonal shifts can contribute to a range of symptoms:
Mood swings and anxiety: Low oestrogen levels can impact mood regulation.
Fatigue: Postnatal fatigue is common, but extreme exhaustion may be linked to iron deficiency or hormonal imbalances.
Vaginal dryness: Reduced oestrogen can lead to thinning vaginal tissues and discomfort during intimacy.
Hair loss: Temporary postpartum hair shedding is common but may be worsened by low iron levels.
Recovery Tips:
Practice self-care and seek support if experiencing mood disturbances.
Consider a protein supplement to aid postpartum recovery and energy levels.
Use a vaginal moisturiser such as YES VM to combat dryness and improve comfort.
If hair loss is significant, have your iron levels checked and consider supplementation if necessary.
5. Tummy Gap (Diastasis Recti)
Diastasis recti occurs when the connective tissue between the rectus abdominal muscles thins and widens to accommodate a growing baby. This is a natural adaptation that will occur in 100% of pregnant women and tends to resolve gradually over time. An early but graded rehab programme helps to re-engage the deep core and transverse abdominal muscles, helping to avoid rectus abdominal overload, whilst regaining core strength and function.
Recovery Tips:
Avoid breath holding whilst activating the core in movements such as lifting or getting out of bed. This will help reduce pressure in the abdominal cavity.
Begin diaphragmatic breathing from day 1 post-natal. This activates the transverse abdominal muscles and promotes healing through the parasympathetic nervous system.
To engage the deep core commence gentle abdominal contractions such as drawing tummy button to spine and pelvic tilts as you feel able.
Book a 6-week post-natal check where a postnatal physiotherapist can assess the severity of diastasis recti and provide a tailored rehabilitation plan.
To conclude, postpartum recovery is a journey, and every woman’s experience is unique. While common pelvic conditions can be frustrating, they are not something you have to ‘put up with’. With the right information, professional support, and self-care strategies, you can regain strength, confidence, and comfort in your body. Whether it’s through pelvic floor exercises, targeted physiotherapy, or using gentle and effective products like YES VM vaginal moisturiser, Pelvic Project can help you take small steps toward recovery can make a big difference in your overall well-being.
Don’t wait these symptoms out alone - get ahead of the game & speak with one of our specialist practitioners.
