It’s a situation I see regularly in my clinic: new mums with vaginal amnesia.
Let me explain vaginal amnesia.
Vaginas are sensitive creatures.
It’s an obvious statement, but it’s worth stating the obvious. They are easily overwhelmed by stress, tension and pain. New mums usually have a fair bit of all three going on. The pain of the stitches might fade fairly quickly (if you’re lucky), and then the aching back and aching shoulders sets in, from all the hours of baby holding, baby feeding, baby jiggling…and the stress of this time goes without saying.
I frequently see new mums for the first time six or so months down the track. It seems to be the time when life is getting (just barely) manageable, and the mum has time to notice for more than a few seconds that things don’t feel right – deep pelvic aching, pelvic dragging, lower back pain. And as for sex! Well, don’t even go there. The pain with sex can hang around a lot longer than what it takes for the stitches to fully heal.
I’ve talked in other posts about the role of the episiotomy or perineal tear scar, and how like any scar, it needs to become flexible and supple again.
But that’s just part of it. This post is about something different.
It’s about those poor, vulnerable, frazzled nerves of the vagina.
Frequently, I do vaginal exams on my postnatal patients, and find that the scar tissue is not the main issue. Instead, the nerves are objecting to any touch. The nerves have been on the defense for so long (often due to prolonged pain, coupled with the effects of stress) that the lightest touch becomes painful. This is seen by gentle, light touch within the vagina being reported as very painful, despite minimal pressure against scar tissue or muscles.
I see this as a situation of unintentional neglect. The focus has been on anywhere but the vagina, and in response, the vagina is crying out for attention and a bit of “TLC”. The new sensitivity is the nerves’ way of expressing a sense of “danger”. This has often started with a general reluctance to touch the area due to early pain due to the inflamed stitches. But this progresses to a persistent fear of pain, a defensiveness of the area. The nerves have “forgotten” how to feel sensation normally. What shouldn’t be painful (like light touch, pressure or stretching of the vagina) becomes painful.
Sex is not on the agenda at first.
When it eventually comes time to go down this road again, there is a great amount of fear and trepidation. This leads to an avoidance of sex – easy to do anyway, when life with a baby is so busy and exhausting! – but this may end up inadvertently making the problem worse.
If you have pain with sex after having a baby, and it doesn’t ease with the first few times, it could be a kind of “vaginal amnesia” developing.
It’s important to see a pelvic floor physiotherapist for evaluation, and a program to help your body get back on track.
Then you can aim to forget all about vaginal amnesia!