"Each time I have sex with my husband, I am reminded of the trauma"
Sexual dysfunction is another common, yet taboo subject. Women with prolapse are often very self-conscious about the changes their bodies have gone through. They are often concerned that intercourse may worsen their prolapse (which is not true) and therefore intimacy can often be forgone, in turn placing extra pressure on relationships.
Many women notice some vaginal laxity after childbirth, and to a degree this can be alleviated with muscle strengthening exercises. It is not the vagina that’s the problem, but the pelvic floor muscle (which lies behind the vagina) which determines vaginal tone and pressure. If the pelvic floor muscle has been overstretched or torn in childbirth (which is common) vaginal tone is reduced, and both partners may notice this during sex. Pelvic floor muscle exercises can help, but if it is a major problem you may want to see a pelvic floor physio, gynaecologist or urogynaecologist. Sometimes vaginal laxity is an early symptom of prolapse.
If there is ongoing scar tissue discomfort or pain following childbirth (or if you have had a significant tear) or gynaeacological repair surgery, it is crucial that you seek help. Simple effective education can help women with this (often embarrassing) topic. The following list provides some tips to improve sexual dysfunction, but it is also important to talk to your GP, gynecologist or physio to get help for specific problems.
Tips for improved sexual function:
- Talk about issues with your partner
- Take more time for arousal
- Concentrate on relaxing your inner thighs, buttocks and lower tummy
- Use a lubricant
- Use non-latex condoms
- Use local oestrogen pessaries or cream
- Don’t forget ‘outercourse’
- Seek professional help early
Finding someone you trust and feel able to talk to about this topic can often be the first step to getting help. In our experience a good women’s health physio can often be the starting point. However, further help from a couples counsellor or sex therapist may be useful.
If you have had gynaecological repair surgery, check with your surgeon as to when you can have intercourse. Due to pain and discomfort after major surgery, there is often a reluctance (from both partners) to resume intercourse. It can take up to 8 weeks for the pain to disappear. If there is ongoing chronic pain you should see a specialist.
Some of this information is taken with consent from Sue Croft’s ‘Pelvic floor essentials’ book.