9 mo PP and stil A LOT of pain. TMI

[icy02]

I am 9 mo postpartum and still can not bear to have intercourse as it is so unbelievably painful. It honestly feels like the doctor sewed me up too tight. Every time we have intercourse it feels like I am stretching (like when you are delivering the head) and have a strong burning sensation. I can feel exactly where I tore and where I was stitched... It is downright horrible. 

My DH and I have tried EVERYTHING. I finally emailed my doctor (she was not the one who delivered me) and she wrote me a prescription for Premarin cream. It is an estrogen cream that she says will help heal and soften the vaginal tissue. She has directed me to apply a small amount of cream at the vaginal opening every OTHER night at bedtime.

I am pretty natural and don't like the idea of using this type of cream, but I am desperate for some change. My poor DH hasn't had a good time in soooo very long. I want to be able to enjoy being intimate with him again.

So I am wondering if anyone else has used cream like this and what are the pros and cons? The research I am finding on line is based on women who use the cream for menopausal symptoms and are using the cream as directed (which is using a applicator and inserting up inside the vagina. Since my doctor has directed me to not use the applicator and use only a small amount every other night, I am hoping it is safe enough to use.. I want any recommendations regarding using this cream, but keep in mind no 'natural' treatments have helped me down there and DS2 is 9 months old... I miss my DH :(

[mwherbs]

The best info about risks is from their site, they are mostly addressing risks of older women who at age 65 were possibly using it for 10 or more years steadily. But if you feel you are in any of the risk categories then talk to your provider. I know that it has worked for nursing moms, I dont know how much it will change if the cause is mainly oversew .

http://www.premarinvaginalcream.com/

[icy02]

I don't know that I was oversewn... At my 6 week PP checkup, my OB-GYN said everything was perfect. I just 'feel' really tight and intercourse rubs on my scar from my tear. Glad to hear that it has helped other mom's though :) Gives me hope!

[member234098]

Ask the doctor who sewed you up if you got a husband's knot, a special knot that will make your vagina tighter and can cause pain.  Get your records.

[Super~Single~Mama]

I would ask to be seen.  I had terrible pain for 11 weeks pp, and when I went for my 6week check up, my midwife said everything was healing perfectly - when in reality I had a TERRIBLE amount of granular tissue (or mucous membrane depending on who you ask - its the same thing different name), and at 11.5weeks pp I had to get it removed.  After that I was pain free in less than 48 hours, with just a teensy bit of pulling feelings after the initial numbness wore off (there was so much I had to be numbed inside and out in order for it to be removed - other people that I know who've had it removed didn't get any pain meds for it). 

[icy02]

Originally Posted by miriam 

Ask the doctor who sewed you up if you got a husband's knot, a special knot that will make your vagina tighter and can cause pain.  Get your records.

OMG! I had no idea such thing existed. I would not put it past the arrogant doctor who delivered me to have done that. It infuriates me all the things doctors want to do to you while in labor and delivery without getting your consent. Most of it we were well educated on and fought off before they even had a chance. If he did this to me I'm gonna stir the pot. I will be beyond pissed!

[tracymom1]

I would make an appointment and see your doc.  I worked in OB/Gyn and the one case that I remember specifically which was very similar to yours ended up being a nerve ending/scar tissue problem.  Sometimes the scar tissue forms in a way that no matter what you do, any pressure or rubbing against it is going to cause discomfort.  We treated it by using a very quick and light cautery to the area of scar tissue.  The patient was absolutely thrilled - when she came in a week later for a checkup, all was healed and the pain was gone.

I'm not saying that this is it, but it is just one more possibility worth looking into!  Good luck!

ETA, if you are breastfeeding, I would not use premarin cream.  I know its "safe" for use during BFing, but it just makes me nervous.  Topical estrogens don't typically enter the bloodstream enough to be passed on in milk or have an impact on your overall health, but the vagina does grow used to having the extra hormone around and eventually slows down its own production of lubricating hormones.

[wombatclay]

I'd call a gyn or midwife who provides "whole woman" services... basically, not someone who focuses mostly on birth, but someone who focuses on gynecological health in general.  I know several people who have had granular tissue, or adhesions, or keloids (or tears that went unnoticed at the time and then healed "off"... this is really common with 2nd degree tears that are actually 3rd degree tears where the anal tissue tear was "missed" due to general swelling in the area or because the tear was "internal").  Ask for a full exam just to rule out anything unusual.

You might see if your library has a copy of Ending Female Pain... it's a great book with lots of advice and ideas for women who have chronic sexual/scar/pelvic pain.  It discusses medico/pharm solutions as well as holistic/alternative solutions to LOTS of different situations and is well worth finding.  I had a 4th degree tear with dd2, and a pelvic organ prolapse, and her book has been a real life saver for me.

In terms of the cream... there are a variety of estrogen creams available for topical application.  They can work miracles on vaginal scar tissue.  But I'd want that full exam with a specialist first so that I knew the estrogen cream was the best option.  I've used Replense (over the counter, non-hormonal, vaginal tissue moisturizer rather than a lubricant) though... I respond really strongly to breastfeeding hormones and found that Replense was a must for anything even remotely like "comfortable" sex during the first 6 months pp (not that I stop breastfeeding at 6mo, it just seems like my body starts figuring things out about then!).  It's sold for pregnant, breastfeeding, and menopausal women and my local grocery store has it with the family planning stuff.

[kltroy]

Sounds like you have two issues going on:

1.  Breastfeeding dries everything out.  This is what your doc prescribed the estrogen cream for, which you may or may not decide to use.  A good lubricant will help a lot with this too.

2.  Pain (aka vulvodynia) during intercourse.  There are many things that can be done for this (most are not terribly interventive) -- I would see a good gynecologist for this.  Among other things, what can happen is that you start to anticipate the pain and this causes you to get tense and not even want to try sex.  A gyn can prescribe some numbing creams that can help you feel more comfortable.  I'm sure there are a variety of other solutions too, but I would start by going back to your doctor and explaining that this is not a dryness/breastfeeding issue so much as a *pain* issue, which may persist beyond when you wean your baby (and estrogen levels return to normal).

[Blue Light]

Any chance you may have a mild yeast infection? After DD1 I had terribly painful intercourse for months (10 or so). I finally went to my PCP to check on the issues b/c I also had a reaction to some gel we used to help with the problem (we tried so many things). She tested for yeast and found I did have an infection. I got difulcan and the problem went away completely. The infection was very mild but irritating so the vagina. I did feel some itching but not much and not the classic symptoms.

I had a tear and stitches as well. So painful! The healing from that was awful. I even went back at 1.5 weeks PP to make sure nothing was wrong. They commented that the sew up job was sloppy but no infection. I thought for a long time that the pain was due to the tear and its healing since this was my first child. But it was the yeast infection. 

With DD2 we worked hard to avoid a tear (and had none!). I didn't have the same pain this time. 

Just a thought.

[penguintattoo]

I had the same problem until I got AF back at 11 months. I went to the doctor and he said it was vulvadynia and gave me a numbing cream that worked great. I don't actually think that was the problem, I think it was just dryness from breastfeeding.