I’d had what I considered to be a great birth. An induction due to an overdue baby, three good pushes, a single pull with a vacuum, a healthy baby and only one stitch. I was up and walking shortly after and everything looked fine at my six week check-up and pap smear.
Sex hurt the first time at six weeks, but hey… doesn’t it hurt for everyone?
Three months passed, and still, gentle, loving sex was painful, too painful to last more than a minute or two. Usually a few specks of blood were left on the sheets. I googled, I asked my mother’s group, I mentioned it to my GP. All normal, they said. We all take different amounts of time to recover from childbirth. Also breastfeeding often made things dry. Maybe try more lube?
Month five, things seemed to be getting worse, not better. My husband wouldn’t come near me, for fear he’d tear me. And if I did convince him to give sex a try, to warm me up, to go slow, to be gentle, to use careful positions (sexy, hey!), the result was the same – tearing of the vaginal opening, bleeding and stinging. He’d have to head off to another room to finish the job for himself, guilty that he’d ‘done this to me again’.
Our baby didn’t sleep more than 40 minutes at a time. She had endless feeding issues. I had recurrent mastitis and blocked ducts. I needed to return to work early. I had significant post-natal anxiety.
Having no intimacy with my husband was the cherry on top that our marriage did not need. But after being given the ‘you’re an over-reacting hypochondriac first time Mum’ treatment whenever I took my daughter to a doctor or nurse, I felt like this must be another ‘everyone recovers at different rates’ scenario.
Month six – sex was unbearable, so it just stopped happening. The tearing was worse, the bleeding was alarming. After our last attempt, I sat down in front of our mirror and had a look. My vagina, my labia were normally a dark pink colour, in late pregnancy they’d ventured into purple territory. There was no denying that now, they were a VERY light pink, and in parts completely white. I booked an appointment with my GP.
When I explained what was happening when my husband and I attempted to have sex to my GP, she asked me if I’d had any stitches. I told her I’d had just the one.
She said it sounded like I was given a ‘husband stitch’, where the vagina is repaired in such a way that it is left tighter for the pleasure of the woman’s male partner. She was visibly furious and said that this was trend that was dying out, but she still saw it from time to time. She asked to examine me to confirm the diagnosis. She took one look.
‘Nope, I’m calling a different specialist for you’, she said. She told me I had lichen sclerosus, and the dermatologist gave me her ‘emergency appointment’ the very next day.
Lichen sclerosus is a condition that largely affects women at the onset of puberty or after menopause, so being in my twenties, I was a very unusual case. As I’ve learnt though while scrolling through the LS support forums – not that unusual.
There is no proven familial link, but I discovered that my mother had been diagnosed with the same condition years before, and that this family connection was also not uncommon. The condition usually presents with itching of the vulval or anal region – I had no itching though, so it had never come up in any of my ‘what’s wrong with me?’ Google searches.
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The itching symptom means the condition is often misdiagnosed as thrush. The whitened skin is also a common symptom, but like most women, I couldn’t say I looked too closely at my vagina… well… ever. It can have the effect of shrinking the opening to the vagina, making sex very painful.
Lichen sclerosus is a chronic, life-long condition. Most health professionals believe it is an auto-immune condition and therefore more likely in women who already suffer other autoimmune conditions, although there is debate that hormonal changes play a big role in its onset. I personally believe this is the case – I had just had my first child, began the mini pill for the first time and was breastfeeding.
Because the condition is ongoing, treatment is too. Steroid creams applied liberally in the initial stages and potentially forever in topical doses are the most common treatment. For most women, no other intervention or biopsy is needed.
My dermatologist wasn’t happy with my saying ‘sex is now bearable’, and persisted on strong treatments until I could confidently tell her ‘sex is enjoyable’. I thank her for this now – when you’re in the ‘Mum bubble’ it’s easy to put aside your own needs. Her support, my steroid creams, my understanding husband and a lot of expensive lubricant have meant that after a break from sex for two months after my diagnosis, we were able to resume our sex life, and conceive our second child a year later.
I write this, because too many women are having painful sex.
We’re afraid we’re overreacting, that we’re still recovering, that our pain won’t be taken seriously. We’re afraid that the issue won’t be able to be resolved, or that any resolution might involve surgical intervention. But sometimes, solutions can come in the form of a simple $12 ointment, and that ointment can change your life and save your marriage.
If any of this speaks to you, please see your doctor, and ask them about lichen sclerosus.
Further information can be found at these websites:
Support can be found through these groups: