Problem with the painful scarring on the perineum
I have a problem with a painful scarring on the perineum.
In this case, much of what is written on the page pain during intercourse is relevant.
It is necessary to diagnose whether the cause of the pain is the scar alone or whether the problem is wider, or whether the main problem isn not something else, such as inadequately healing birthing injury, loosening of the vaginal wall , pelvic organ prolapse , insufficient lubrication, lichen sclerosus (autoimmune disease of the external genitalia), vulvodynia , vaginismus, etc.
How the problem is diagnosed
Diagnosis is based upon a detailed consultation alongside a urogynecological examination and, if necessary, an examination by a sexologist. It is important to ascertain whether the pain is constant or if it only occurs in in certain situations. A typical situation is during sexual intercourse.
This is why an examination of both the exterior and interior are necessary. The diagnostic algorhythm is greatly helped if you, yourself, can show the place where the pain is occuring.
How the problem is treated
The treatment stems from the reasons found for your problems. The approach is often interdisciplinary, which is why urogynecologists, sexologists, and psychologists are all present at our Center for Pelvic Disorders. The primary cause of your problem often leads to secondary psychological problems (fear of, and aversion to your sex life, not enjoying life in the way you would wish to...).
In the following list, we offer just a selection of the possible treatments on offer:
Application of lubricating agents
This comprises the most simple solution in cases of lower lubrication, which is relatively common in postmenopausal women. This treatment can be simply managed by you, yourself, and does not require our assistance.
CO2 laser brings about changes at the point of application, particularly to the vaginal tissues, called collagen remodelling, the basic protein building blocks of connective tissue. The heat created leads to vapourization of water from these tissues, and hence to their drying. This leads, in turn, to an increase in the intercellular mass and the activity of the connective tissue cells (fibroblasts), which contribute to the production of new collagen. According to an Italian study, this process leads to an improvement to all aspects of sexuality. Indeed, 85% of women, who were sexually inactive prior to the treatment began their sex life again.
Physiotherapy
Local application of analgesic preparations
If the pain is emitted from a specific place which can be identified, then the direct application of preparations of analgesics, corticoids, or antibiotics to the painful place is possible. In the event of a positive effect, it is possible to repeat this application.
Surgical correction
This is based on the identification of the particular point of dispareunia (unhealed birthing injuries, a scar on the perinium, or a prolapse) followed by surgical repair (developing scarring tissue or reducing the prolapse). It is important to mention that even with sufficient removal of scarring, the same problem can still occur again, because the cause can be related to your specific type of healing process.