Q I gave birth three months ago, but it is still quite painful to have sex. The pain is in my episiotomy scar. What can I do?
A Dr Vijay Roach, obstetrician, says: An episiotomy is a cut made with scissors at the introitus (opening of the vagina) to allow room for the baby’s head and to reduce the risk of overall perineal trauma. There is a lot of debate as to whether it is better to tear rather than to have an episiotomy. The midwife or doctor should use their judgement at the time.The scar tissue can be painful but in most women this resolves after six to eight weeks. In breastfeeding women, their oestrogen levels are low and this can make the vagina dry and make intercourse uncomfortable, even in a woman who has had a caesarean section. After three months it is unusual to still find sex painful and you should see your doctor to check whether there is scar tissue that may need surgical treatment. Other things that may help are lubricants, oestrogen creams and gentle massage.