DYSPAREUNIA (PAIN DURING SEX) AFTER BIRTH
I’ve determined to deal with this matter following a number of circumstances of girls who’ve reported to me throughout gynecological examination episodes of ache throughout sexual activity after the start occasion. readability.
Let’s begin by saying that, in medical jargon, such a ache known as Dyspareunia. It’s a symptom that may have an effect on the teenage lady in addition to the mature girl.
Within the particular case, nonetheless, we concentrate on the symptom that seems after childbirth.
There are a number of components that may result in dyspareunia:
– sequelae of the episode. Episiorraphy is the suture that’s carried out on the vulvar degree following the execution of the episiotomy (reduce that’s made by the physician or midwife to facilitate the exit of the fetal head when it’s realized that the girl is vulnerable to main lacerations or when it’s essential to speed up the expulsion of the fetus). The therapeutic of the episiorraphy
can result in the formation of hardened and retracted tissue, particularly if within the quick postpartum there’s an an infection within the vulvar such that the wound needed to heal “by the second intention”.
In observe, it might occur that regardless of the wound having been sutured (episiorraphy), the tissue, as a substitute of therapeutic, reopens after which heals taking longer, having to attend for the formation of wholesome tissue that reforms from the underside up.
Nonetheless, this “healed” tissue is usually retracted and hardened with the ensuing look of dyspareunia because of a really sturdy ache particularly on the entrance to the vagina;
– dyspareunia linked to myalgia. What is set is a contraction of the muscle surrounding the vagina, triggered by a hard and fast ache which, clearly, worsens throughout intercourse makes an attempt. On this case, there are stronger factors of tenderness equivalent to the areas of muscle insertion, liable for the painful signs felt contained in the vagina;
– vaginal dryness.
The start occasion causes a drop in hormonal ranges with a consequence. First of all, on the temper however typically additionally on the vaginal lubrication.
– vulvar vestibulitis. We’re speaking about an inflammatory occasion that happens primarily on the entrance to the vagina, linked to microtraumas that happen when sexual activity takes place at “unsuitable” occasions, not permitting the girl to be correctly lubricated. Vestibulitis can be related to hypercontractility and muscle ache.
The remedy clearly depends upon the triggering trigger. On the whole, it will likely be essential to:
– Handle and resolve the issue of poor lubrication that may trigger vaginal dryness and / or vulvar vestibulitis with native estrogen remedy in order to not intervene with breastfeeding;
– Addressing and resolving muscle hyper-contractility with self-massage or by sending the girl to rehabilitation remedy facilities with particular methods;
– scale back irritation and native ache, with a vaginal gel based mostly on aliamides, capable of act on vaginal irritation and promote correct therapeutic. The gel has even higher and sooner outcomes whether it is utilized within the vagina and on the vulva, the place the scar is situated, with native massages of 4-5 minutes, two or 3 times a day.
It must also be careworn the significance of ample intimate hygiene in girls who’ve given start.
In reality, it’s important:
– an applicable intimate hygiene with therapeutic soaps that respect the vulvar pH and scale back vulvar and vestibular irritation;
– self-massage with hypericum or aliamide oil-based gel;
– a particular gymnastics for the rehabilitation of the pelvic ground muscle groups, that are very lax and relaxed after start.