Scar tissue and tightness after episiotomy — anyone else experienced this?

[trufflesandolives]

Hi everyone,

I had an emergency episiotomy and a big bleed during delivery. Since then, intercourse has been painful and the vaginal opening feels smaller and tight, as though there’s scar tissue restricting it. My GP recently confirmed there’s a lot of scarring and said the skin looks thin and fragile. They mentioned that revision surgery might be needed, but weren’t sure what the options are and they made a referral.

Has anyone here dealt with significant scar tissue or tightening after an episiotomy?
• Did you have any kind of procedure or treatment (surgical revision, laser, steroid or estrogen cream, etc.)?
• Did things improve over time or with physiotherapy or massage?
• Were you advised to avoid vaginal delivery in later pregnancies?

Any insight or experiences would really help — even just to know what to expect or ask about next time I see a specialist.

Thank you 💜

I had this, although it sounds like yours may be worse than mine was. Mine was very tight, and I used to get a sharp stabbing pain. Interestingly it was much better after delivering my next child 2 years later (vaginally, much easier birth than the first)

How long ago was the delivery? & I hope it's not too crass to ask - how many times have you tried intimacy? The first few times do hurt as the scar tissue stretches.

It can help longterm to do scar massage & keep oil in the bathroom to pop on a cotton pad and swipe to promote healing. TMI potentially but going on top and using way more lube than you would think you need helps in the moment.

Are you breastfeeding? If you are, the hormone changes can contribute to discomfort.

If you can get a referral to a woman's health physio, or can afford to go private and self refer, they're much more experienced in these areas than GPs.

My second delivery tore naturally on the same line and healed much much better for me.

I had this (but from a tear). We were using condoms which really didn't help and then as for @MountainBiker it pretty much resolved itself after DC2 was born somehow. In retrospect I also wonder if I was given a 'husband stitch' when they sewed me up, but of course no way to know now.

After my first, the scarring meant sex was painful and then uncomfortable for almost a year but still felt strange. As others have said the second fixed it (tore rather than cut, stitched better I guess)
So time and more babies helped me.

Yes, don't wait to get it sorted out. I never regained any meaningful feeling in the perianuim and by the time I asked for a repair they wouldn't.

It stopped hurting but sex was meh. That bit of the body gives you the nice feels.

The delivery was 1.5 years ago and I've been intimate around 3 times since then... I'm still breastfeeding. Being on top and using lots of lube is definitely the only way but someone said it's actually bad to persevere when it hurts as it can make it worse...

I was going to ask if you were still breastfeeding? For me with both babies it was excruciating to attempt sex until I had stopped breastfeeding. I was even referred to a gynaecologist. First labour like yours involved forceps, episiotomy and a huge tear. Gynaecologist prescribed these dilatory things which didn't help. I thought I was doomed forever. Stopped breastfeeding and it all became much more normal again. I had the same thing with baby number 2 despite that not involving anywhere near as much damage. Clearly just some weird hormonal issue for me.

For me, persevering through it (slowly!) helped. I don't have a medical background but my thought is the tissue needed to adjust - it took a handful of semi-regular times before it felt better. Big gaps between brought it back to the initial pain. I also did scar tissue massage for a few weeks before even attempting it, as the internal scarring felt tight.

Breastfeeding changes all of the hormones involved as well. It helps when you get your cycle back but even then it's still impactful.

I had this with my episiotomy. It completely resolved after my second child was born. I tore that time, but had no issues with recovery.