Give your vagina some damn respect.

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Since having child #2, sex has been rather uncomfortable. The weird part is that #2 was a failed VBAC, so in theory, everything ought to be hunky dory down there. I labored with both kids, but since I didn’t reach a pushing stage. Nevertheless, my perineum is sore so we have to be careful about position, which also happened after child #1. The bigger issue is that sex is just plain uncomfortable, even with lube. Help! -Lisa

Pain during sex is never good, Lisa — that is unless it involves consensual whips, chains, and nipple clamps. It’s not that uncommon for postpartum moms to have some discomfort, which can often be solved with a little extra foreplay, lube, and some creative positioning.

However, if it goes beyond a few months, even with the lack of sleep, breastfeeding dry spells, and recovering postpartum body image woes, there’s definitely a sign that something more significant could be wrong.

Now most issues often relate to women who have had vaginal births, particularly those who experienced tears or an episiotomy. Without the proper lubrication, that already pretty sensitive area can be aggravated, especially if there’s any sort of scar tissue. If the pain continues, there’s a chance that you could be dealing with a Frankengina, in which case, you should definitely check with your OB-GYN or midwife. Keep in mind that since OBs and midwives are not plastic surgeons, complicated tears might have wreaked a little havoc on their repair job.

C-section moms generally have their own set of issues when it comes to postpartum pain, mostly related to their incision area, which can be irritated with friction in the wrong position. But given that the baby exited their belly and not their vagina, perineal or vaginal pain is pretty rare.

In two words, you’re special!

So let’s try to figure out exactly what could be going on.

1. Congrats, you’ve got an STD!

Based on your description of the location of the pain, it is entirely possible that you have something like HPV, which has common symptoms of acute pain in the perineal area.

Who knew?

Thankfully, HPV can be easily diagnosed, however it’s not actually curable, though the disease usually clearing up on its own in a couple of years. Just in time for the terrible twos!

However, unless you’ve been enjoying painful sex with someone else, or you suspect your spouse is getting a little extra on the side in his free time, this is probably something that you can rule out.

2. Welcome to menopause!

All right, so that’s not completely accurate, but it’s more likely that you’re experiencing some pre or perimenopausal symptoms like the thinning of the perineum. This can cause the exact type of pain you’re describing in many women, regardless of their age.

You can try a few herbal remedies, or just hit your OB or midwife up for some prescription estrogen cream, and you should see results pretty quickly.

Keep in mind that none of this advice should replace a good old visit to your doctor. A hearty ass smack to you for reaching out to your favorite sex columnist, which is a step in the right direction. Unfortunately, most women do not take such active steps and instead suffer in silence, complain of bad headaches, and flip on some crappy reality show while their husband beats off in the shower. Or worse, they blame themselves or motherhood for stealing their libido.

Whether or not you have a simple but painful problem like Lisa, there’s a lesson for every mom. A little bit of pain or discomfort immediately postpartum is pretty common. But if your kid is walking and talking and you’re masking your painful yelps as orgasmic screams then it’s time to get some help.

You’ll run your kid to the pediatrician for a runny nose and you’ll pop an aspirin if you have a headache. Give your vagina the same damn respect.

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