Painful Sex After Episiotomy

“Episiotomy, also known as perineotomy, is a surgical incision of the perineum & the posterior vaginal wall generally done by a midwife or obstetrician. Episiotomy is usually performed during second stage of labour to quickly enlarge the opening for the baby to pass through” [1]. In some cases, weeks after this procedure, having sex can be unbearable. – And this is why consulting a Pain Specialist is essential

How Your Sex Life is Affected By a Cut or Tear (Episiotomy)

Like so many other aspects, the fall-out of having an episiotomy, depends on the individual, and their particular circumstances. When it comes to the healing process, 10 days after the event, the stitches (which do not need to be taken out), should dissolve automatically. This means that after 14 days post-delivery, this intimate part of your body should be healing quite well [1].

Differences in Circumstances

“If you had stitches after an episiotomy or a first- or second-degree tear, it can take up to a month to heal . For third & fourth degree tears, wait until you’ve stopped bleeding & your tear has healed before having sex again” [1]

This is very important guidance, and being in a rush to resume your sex life, should be avoided, as if you persist, you can cause further trauma, inflammation, and even infection.

In the case of stitching, once your body is fully healed, and you feel ready to resume your sex life, you still have to be mindful of what you have been through, and err on the side of caution. – This means resuming sex gently and slowly. One good strategy is to restrict sex with your partner, by just using specific positions. – These should limit penetration, and lessen any pressure on the places where you had your stitches [1].

What Should I Do When Sex is Too Difficult or Painful?

As the NHS states: “If you’ve had a tear or an episiotomy, pain during sex is very common in the first few months. If penetration is painful, say so” [2]

If you are in this scenario, you can rest assured that countless other women are going through the same, and that you are not alone. There is help available, and this is where an experienced Pain Specialist comes in. – A consultant who has spent many years working in this particular field. When you arrange an online or in-person appointment, they will review your medical history, look at the details of your pregnancy and delivery, and ask you pertinent questions about your pain. They will then devise a Holistic Personalised Treatment Plan, which you will be able to get started on right away.

References

[1]. NCT (2021). “Sex after a baby: 10 questions to ask yourself.”
https://www.nct.org.uk/life-parent/sex-after-baby/sex-after-baby-10-questions-ask-yourself

[2]. NHS (2021). “Episiotomy and perineal tears.”