Q: I am a first-time mum. My baby is now two months old and still on full breastfeeding. My husband wants to have sex with me, but I am frightened of pain. Besides, I have no desire. Can I resume sex now? Will it be painful? My friend told me that as long as I breastfeed my baby, I cannot get pregnant. Is it true?

A: Sexual intercourse may be resumed after the red or brown vaginal discharge called lochia has stopped and stitches at your vagina have healed. Usually, most women would have recovered by six to eight weeks after delivery.

Several factors can affect your sexuality besides the fear of pain.

»You may be suffering from lack of sleep and exhaustion attending to your baby's endless needs.
»You may be so tired by the demands of being a new mother, that you have little time for your husband.
»Sex seems like another physical demand on your body so that you may not want to connect with your husband emotionally.
»Fear of another pregnancy may also be an inhibiting factor.
»Breastfeeding suppresses ovulation. This would reduce the amount of female hormone (oestrogen) circulating in your body to below normal levels, causing vaginal dryness and a general dampening of sexual desire.

However, every woman is different, and some nursing mothers report that breastfeeding does not affect their libido.

Physically, you may notice a change in the size and shape of your vagina after birth. For the first few times, sex may be painful due to vaginal dryness. Use a water-soluble lubricant such as KY jelly or Femglide, and try positions that allow you to be in control of penetration. You may experience 'let down' (leaking of milk) during sex. This is normal and there is no way to prevent it.

While it is true that, on average, most women who breastfeed fully will not be fertile for about six months after childbirth, it is not a foolproof way of contraception. You can become pregnant again even before you have your first period.

SOURCE: DR PETER CHEW, CONSULTANT OBSTETRICIAN AND GYNAECOLOGIST AT GLENEAGLES HOSPITAL

Dr Chew is also a founding member of aLife, a voluntary welfare organisation dedicated to nurturing a healthy respect for fertility and family life. For more information, visit www.alife.org.sg

This story first appeared in Mind Your Body on Jan 3, 2007.