How Pelvic Girdle Pain Impacts Mental Health and Sexual Function Postpartum.

Pelvic pain can impact our mood, sexuality. It may even affect our relationship.

Many of the patients we see are navigating a mix of pelvic pain, sexual dysfunction, anxiety, depression, and chronic pain. These experiences often overlap, and part of our work is helping people understand how pain, mood, and sexual wellbeing influence one another. When we zoom in on pelvic girdle pain specifically, the picture becomes even more interesting.

What Is Pelvic Girdle Pain?

Pelvic girdle pain is typically described as pain “between the posterior iliac crests and gluteal folds, particularly near the sacroiliac joint” (Simonds). In everyday language, it’s discomfort in the very low back and buttock region.

It’s common during pregnancy and postpartum, and for some, it can significantly affect daily function in the fourth trimester. Many people are familiar with peripartum symptoms like low back pain, urinary leakage, pelvic organ prolapse, pain with intercourse (dyspareunia), and postpartum depression. But what about pelvic girdle pain specifically? How does it shape mood, sexuality, and overall wellbeing?

How Common Is Pelvic Girdle Pain?

Research shows that about 20% of women experience pelvic girdle pain during pregnancy, and most recover within 3–6 months after giving birth. Still, 16–31% continue to experience persistent pain beyond that window. Chronic pain is generally defined as pain lasting longer than 3–6 months.

One clear pattern emerges: The more severe the pain during pregnancy, the more likely it is to continue postpartum (Rexelius et al.).

Pain, Mood, and the Nervous System: A Two‑Way Street

Pain and emotions are deeply interconnected. Studies show that our emotional state can influence how we perceive pain, and pain can heighten feelings of anxiety or depression (Roy et al.). This is especially relevant during pregnancy and postpartum, a time already full of physical and emotional shifts.

Pelvic girdle pain can originate from many different tissues—joints, ligaments, muscles, fascia, and both peripheral and central nerves. This complexity can make the pain feel unpredictable and harder to manage, which understandably affects mood.

💗 What About Sexuality?

Research exploring sexuality in postpartum women, those with and without pelvic girdle pain offers helpful insights, though it also raises new questions.

Pain With Intercourse

Some studies show a connection between pelvic girdle pain and sexual dysfunction. Even though pelvic floor strength was similar between groups, those with pelvic girdle pain reported more pain during intercourse. This suggests increased tension or tenderness in the pelvic tissues, which may lead people to avoid sex as a protective response (Rexelius).

Sexual Satisfaction

During pregnancy, women reported lower sexual satisfaction overall, regardless of whether they had pelvic girdle pain. At 6 months postpartum, satisfaction levels were similar between those with and without pain, though neither group had returned to pre‑pregnancy levels. By 12 years postpartum, most women reported being satisfied with their sex lives again (Mogren).

The suggestion is: The longer someone lives with pain, the more likely they are to develop coping strategies that help them navigate it positively. Pain seems to affect satisfaction with sex lives, but it hasn’t been shown to lower desire, arousal and orgasm. 

🍃 Ultimately, each person’s experience is uniquely theirs and each person’s treatment must be tailored to their specific needs. Foothill Physical Therapy will assess your physical needs while keeping in mind your experience and expectations to help you develop coping strategies, build resilience and meet your intimacy goals. 

Schedule Now

References:

Rexelius, N., Lindgren, A., Torstensson, T. et al. Sexuality and mood changes in women with persistent pelvic girdle pain after childbirth: a case-control study. BMC Women's Health 20, 201 (2020). https://doi.org/10.1186/s12905-020-01058-7. 

https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-020-01058-7

Simonds, Adrienne H. PT, PhD1; Abraham, Karen PT, PhD2; Spitznagle, Theresa PT, DPT, WCS3. Clinical Practice Guidelines for Pelvic Girdle Pain in the Postpartum Population. Journal of Women's Health Physical Therapy 46(1):p E1-E38, January/March 2022. | DOI: 10.1097/JWH.0000000000000236 https://journals.lww.com/jwphpt/fulltext/2022/01000/clinical_practice_guidelines_for_pelvic_girdle.9.aspx

Mathieu Roy, Mathieu Piché, Jen-I. Chen and Pierre Rainville pierre.rainville@umontreal.ca Authors Info & Affiliations. Cerebral and spinal modulation of pain by emotions. Edited by Antonio R. Damasio, University of Southern California, Los Angeles, CA, and accepted by the Editorial Board September 28, 2009 https://www.pnas.org/doi/full/10.1073/pnas.0904706106