Sex after the delivery. Why it is sick?
Restoration of the sexual relations after the delivery sometimes can be connected with various problems. One of them - a dispareuniya - discomfort or pain which are felt by the woman at sexual intercourse. In what the reason of these unpleasant feelings and how to struggle with them?
What is a dispareuniya?
the Sexual relations in a married couple is recommended to be renewed not earlier than after the end of the postnatal period which lasts 6 - 8 weeks. During this time there is a restoration of the normal sizes of a uterus, the tone of muscles of a vagina and a pelvic bottom comes to an initial state, bloody allocations from a genital tract stop. Also during this term there is a healing of grazes on mucous a vagina and vulvar lips, healing of seams on a neck to a uterus and a crotch comes to the end, formation of a hem after operation of Cesarean section comes to an end.
However even after passing of the specified term at sexual contacts after the delivery many women feel discomfort or even painful feelings. At long existence similar symptoms can reduce considerably quality of life, worsen the relations in a married couple. It is accepted to call these clinical manifestations the term “dispareuniya“.
In a broader sense the dispareuniya is a kind of sexual dysfunction in couple. It is characterized by inability to reach an orgasm at the normal course of sexual intercourse with the constant sexual partner. In narrower aspect understand various painful and unpleasant feelings in genitals arising at sexual contact as this term. After the delivery the dispareuniya meets rather often - from 20 to 40% of cases.by Dispareuniya`s
it is subdivided on superficial and deep. At a superficial dispareuniya unpleasant and pain arises at the time of a penis entrance to a vagina. At a deep dispareuniya the discomfort arises, as a rule, in a vagina, in the bottom of a stomach, in lumbar area.
of the Trauma and surgical interventions
can be the Cause of pain at an entrance to a vagina injuries of a vagina, a crotch, and also surgical interventions on genitalia at the time of delivery. Especially high loading is the share of muscles of a vagina and a crotch during the patrimonial act. They take part in formation of the patrimonial channel on which there passes the fruit. Ruptures of a neck of a uterus, vagina, crotch are quite often observed. Quite often at the time of delivery there is a menacing rupture of a crotch which is the indication for a crotch section.
At the subsequent suture on the damaged sites not always manages to restore completely anatomic integrity of genitals, quite often there is a scarring of fabrics, there are inflammatory processes in the field of postoperative seams. All this leads to violation of blood supply and an innervation of genitals and, respectively, emergence of pain at sexual contact.to
For strengthening of muscles of a pelvic bottom and improvement of blood circulation in them recommend special exercises. At the same time in a prone position or sitting the woman quickly reduces vagina muscles by 1 - 2 seconds, then weakens. About 25 - 30 reductions 3 - 4 times a day are recommended to do. Unpleasant feelings can remain in the field of a hem about several months. As a rule, at good result of healing (without infection, formation of rough cicatricial fabric) discomfortable feelings pass independently. The gymnastics, use of various cosmetology rassasyvayushchy means can accelerate rehabilitation a little. If on the place of a section (gap) the rough hem as a result of infection, inflammations, then upon termination of the period of a lactation or not earlier than in 6 months after the delivery it is possible to consult concerning surgical treatment - excision of cicatricial fabric was formed.
Prevention of formation of rough hems is observance of rules of hygiene in the postnatal period. In the presence of seams on a crotch their daily processing with solutions of anti-septic tanks is made (iodine, solution of diamond green), physiotherapeutic procedures are carried out (laser therapy, a magnetotherapy, ultrasonic therapy on area of seams). It is not recommended to sit down on a crotch within the first month after the delivery.
of the Infection
Pain can be caused in an entrance to a vagina by local urogenital infections (mycoplasmas, ureaplasmas, kandida, gardnerella, hlamidiya, viruses of sexual herpes etc.) which cause inflammatory processes of a mucous membrane of a vulva, vagina and neck of a uterus, and also body of a uterus and its appendages. In the presence of inflammatory process in genitals of fabric of this area are easily injured, the slightest friction causes painful feelings and discomfort. Manifestations of inflammatory process in genitals are: burning, an itch in a vulva and a vagina, plentiful mucous or slizisto - purulent allocations from a genital tract, sometimes with an unpleasant smell.
For elimination of this reason needs carrying out inspection on existence of urogenital infections (dab from a vagina on flora, PTsR - diagnostics, bacterial crops from a vagina and the channel of a neck of a uterus). By results of the conducted examination the general and local antibacterial and anti-inflammatory therapy usually is appointed: toilet of genitals with solutions of anti-septic tanks, vaginal candles with anti-inflammatory effect. In the absence of breastfeeding courses of antibacterial therapy taking into account sensitivity of the activator to antibacterial preparations are appointed. If the woman nurses, purpose of a course of antibacterial therapy till 7 days is possible. During reception of antibiotics it is recommended having rummaged in breastfeeding. At the same time the woman decants the milk which is formed at her, and the child is temporarily transferred to feeding by the adapted dairy mixes. However most often during breastfeeding treatment by local means (vaginal candles, tablets) is appointed. At the same time antibacterial therapy is carried out after the end of breastfeeding.to
needs More serious treatment with interruption of breastfeeding if the inflammation in a vagina is caused by microorganisms which without serious antibacterial treatment can lead to distribution of an infection, development of complications. It is possible to carry gonokokk to such microorganisms, trichomonads, hlamidiya, etc.
vagina Pain at sexual contact is most often observed by
at hormonal changes after the delivery: to insufficient production of female sex hormones - estrogen against breastfeeding. These hormonal features lead to dystrophic changes or an insufficient lyubrikation (production of greasing) mucous vaginas. The vagina cavity at the same time is not extended and does not extend in response to excitement therefore at sexual intercourse there are unpleasant feelings. For the purpose of elimination of this problem it is recommended to use during sexual intercourse the moisturizing gels for the intimate purposes (lyubrikant) which eliminate dryness in a vagina. After the breastfeeding termination similar symptoms, as a rule, pass independently.the Rupture of sheaves
Sometimes pain at introduction of a penis to a vagina is felt by
in the bottom of a stomach. Such phenomenon is quite often observed if in labor there was a rupture of the sheaves supporting a uterus. Kresttsovo - uterine sheaves are the main device fixing a uterus in a cavity of a small pelvis. During pregnancy quite often there is a weakening of the copular device of a uterus, and in the course of childbirth such complication as a gap kresttsovo - uterine sheaves is possible. At the same time further there is a restriction of mobility of a neck of a uterus, as causes development of a pain syndrome at sexual contact. For treatment of similar complication the medicines, physiotherapeutic procedures (an electrophoresis on area of a uterus and appendages, laser therapy, a magnetotherapy) possessing the rassasyvayushchy action directed to solderings - the tyazh of connecting fabric shrouding fabrics and bodies of a small pelvis are appointed. Solderings can be the cause of pains. The physical therapy helps to achieve reduction of expressiveness of adhesive process in bodies of a small pelvis, to increase mobility of a body and neck of a uterus, as leads to disappearance or reduction of a pain syndrome.
of Pathology of a backbone
of Pain, caused by pathology poyasnichno - sacral department of a backbone, usually begin to disturb the woman from the second half of pregnancy (after 20 weeks). Similar pains arise at change position of a body (turns, inclinations, walking), quite often give to legs. Most often such pains have changeable character, can amplify at sexual intercourse. Their emergence is connected with change of anatomy of bodies of a small pelvis during pregnancy (lengthening of ligaments of uterus, increase in the sizes of a uterus), upon termination of the postnatal period similar pains are usually caused by the shift of vertebras in poyasnichno - sacral department of a backbone, infringement of nerves, a muscle strain of lumbar area and a forward belly wall.to
For prevention of developing of similar pains recommends carrying a prenatal and postnatal bandage which interferes with weakening of muscles of an abdominal tension, the shift of the center of gravity at increase in the sizes of a uterus. The swimming, physical exercises directed to strengthening of muscles of an abdominal tension, muscles of a back, hips are after the delivery recommended. It is also useful to sleep on the orthopedic mattress promoting maintenance of a normal muscular tone, reducing load of a backbone. At the expressed pain syndrome in lumbar area consultation of the neurologist, reception of vitamins of group B, the preparations improving microcirculation (blood circulation on small vessels) in all bodies and fabrics, sedatives is recommended surely. After reduction of expressiveness of a pain syndrome the good effect gives also carrying out a course of manual therapy which is usually directed to restoration of a normal anatomic structure poyasnichno - sacral department of a backbone.
In certain cases pain disturbs the woman not during sexual intercourse, and after it. In similar cases sexual intercourse, as a rule, is not followed by emergence of an orgasm. The stagnation of blood in bodies of a small pelvis which is usually accompanying chronic inflammatory processes in genitals is the reason of these pains. After the delivery such complication as an endometritis - a uterus cavity inflammation can develop, is more rare - salpingooforit - an inflammation of appendages of a uterus. It is connected with decrease in immunity after the delivery, raised physical and nervously - mental load of the woman`s organism, change of anatomy of bodies of a small pelvis, formation of a wound surface in a uterus cavity after office of an afterbirth.the timely and carried-out in full treatment of inflammatory diseases is After the delivery important
. After carrying out a course of antibacterial, anti-inflammatory therapy for reduction of developments of stagnation in bodies of a small pelvis use of the gynecologic massage directed to improvement of blood circulation in female genitals, acupunctures, physiotherapeutic procedures is recommended. Gynecologic massage, as well as any other course of massage, includes several sessions. During massage the woman lies on a gynecologic chair, one hand of the doctor or the midwife trained in technology of massage is entered into a vagina, another by means of a number of special receptions masses bodies of a small pelvis through a forward belly wall. Massage is rather effective at a number of gynecologic diseases, but now is used seldom in connection with time expenditure which is necessary for procedures. From the listed techniques more often appoint physical therapy.
Irrespective of the reason causing pain or discomfort at sexual contact, the woman it is necessary to see a doctor to the obstetrician - the gynecologist. After detailed inquiry, survey and inspection the doctor will be able to pick up individual treatment. In general, with the therapeutic purpose at a dispareuniya gynecologic massage, acupuncture, physiotherapeutic techniques, gymnastic exercises are widely used. Complex treatment joins also occupations with the psychotherapist - the sexologist. The help of this expert is important as the psychological conflict, the rejection between sexual partners connected with possible change of relationship in a family after the delivery, change of roles of the spouses who became parents can be the cause of a dispareuniya. Besides, even in the presence of other physiological reasons the help of the psychologist can be necessary to overcome the fear of the woman connected with anticipation of pain which she feels before each sexual intercourse.the Prime cause to reveal
rather difficult, but if it works well, then treatment is directed, first of all, to its elimination. In certain cases consultations of adjacent experts - the urologist, the proctologist, the neurologist, the endocrinologist etc. are required. It helps with identification of the true reason of sexual violations and the choice of the most effective treatment method in each case.