Problems with episiotomy after 10 years?!

[notforthefainthearted]

First of all, apologies for tmi.

Wasn't sure if I should put this in the Menopause section but opted for here.

I have 3 children, the youngest 10 years old, all vaginal births, last two were 9 lb 1 and 9 lb 8 resp. I had episiotomy with all three -actually I'mnot sure if the last was cut or if I tore.

First two episiotomies healed nicely, no problems. The last was quite a different matter. It was a big baby and a very quick birth. I had stitches and was very swollen and bruised afterwards, had a lot more pain than with the others. I was 37 though, as opposed to being in in my twenties with the first two.

So, I have had intermittent problems, i.e. a little discomfort, almost pain sometimes during intercourse. Recently I have been having more pain in that area. It seems to become sore regularly and occasionally there is a little blood - I know this is from my perineum and not cycle related.

I am finding this very difficult to deal with, painful when sitting,I daren't have intercourse, I've almost stopped wearing jeans because they seem to "chafe".

Wondered if anyone else is having this problem or has had this problem and is there anything I can do?

I should add that I'm 48 and probably perimenopausal, I've a referral to see a gynecologist in March about other problems which may or may not be perimenopause problems - bleeding during cycle mainly.

I usually shower but am trying to have salt baths to soak the area - using dead sea salts as I have skin problems anyway and it's meant to help them.

I tried organic aloe vera gel but it stung like crazy!

Help! I'm a bit depressed anyway and am just feeling really down about this. I don't want to go back to my GP and will wait until I see the gynecologist in March but just wondered if there's anything I can do to help in the meantime.

[Mskk78]

I had an Episiotomy 26 years ago when I had my first son he was 9’2 . I had two other children after that . I had a stage 2 Episiotomy. And for some reason at age 41 I decided to take a mirror and check my private area. The reason I did that was to check myself, I felt like I keeped scratching myself with the toilet tissue. And to my surprise saw something different then what looks on the outside. I no rice that I can see a hole and I can see my hymen. I am depressed and I am under a lot of anxiety over this. I want to know if it would rip I want to fix it.

[PollyPerky]

TBH a prolapse doesn't bleed. If it's really bad- ie vaginal walls, or bladder or uterus coming right out of the opening - then it might get chaffed but bleeding as such is not a symptom. And you'd be able to see this with a small mirror!

It sounds as if your scar tissue has changed. This can happen when you reach peri because your oestrogen levels will be falling. This can cause tissues to shrink and become drier.

Vaginal and vulval areas can wrinkle without oestrogen (lovely!) and you lose the fat and cushioning that kept you comfortable.
The inner and outer labia shrink (well, they do!) so the whole area is different.

If this is what is happening then you need something like topical oestrogen- it's a small tube of cream- to use. But you need to see a gynae who knows about all of this. You might even need another small op on your scar to relieve any pressure but again a vulva expert is what you need so it doesn't get worse.

Not sure where you live but what you need is a gynae who is experienced in dealing with knackered perineums! If private treatment is an option I can send you some links to drs- PM me.

[izzypoo0209]

Might not be menopause related, like I said, I'm 24 & definitely not going through menopause but have the same problem.

[izzypoo0209]

I'm 24 & had my daughter 3 years ago. The scar where she tore me is now all of a sudden real red and sore too.

[notforthefainthearted]

Thanks unexpecteditem I will look that up.

[UnexpectedItemInShaggingArea]

Sympathy for you OP and everyone else who suffers in this way.

I have also had problems (though not as much as you I think) after a traumatic birth and not had much advice from my gynaecologist.

Someone recommended Balance Activ to me, thought I would mention it.

[notforthefainthearted]

Well, it certainly seems to be menopause related, as some of you seem to be in the same situation.

Jelly, all I had time for today was to nip into Savers where they had a bottle of almond oil for £1, it lists almond oil as the only ingredient so I hope it will be ok.

I will bear the thrush thing in mind if the oil no longer helps. I'm just relieved that it no longer hurts at the moment.

I'm so sorry that others are suffering also with this. I agree with Jelly about trying to get a second opinion.

[Jellykat]

mangledmess Your situation sounds awful, so sorry..
Have you thought about a second opinion? I went to a gynae a couple of years ago who was horrendous, he got cross with me because i dared to ask questions, and i didn't trust what he was saying for some reason.. went back to my GP and explained why i wanted a second opinion, she re-referred me, and 3 months later, Voila! the 2nd gynae found 2 fibroids.. now don't tell me they'd mysteriously grown in 3 months
If you get on ok with your GP i'd go back and explain how this gynae has made you feel and ask for another.. worth a try?

notfor So glad its helping a bit! hope it sees you through for a while.
Boots and Lloyds both do an Almond oil BP, which you can also bung in your bath (just a few drops) for the rest of you, it makes your skin feel lovely afterwards

[stomp]

Welll my scar tears . It started when I was approaching the menopause and things started to dry out ever so slightly. I saw a consultant who said my scar had 'tighten up' and he could repair it but couldn't give any guarantee about the healing process in such a difficult area. I decided not to go ahead on the understanding that I could go back at any time for the repair if I felt the need. I have been prescribed various hormone creams over the past 6 years, and used Replens and vagifem, unfortunately most things sting like mad so I use hrt creams externally when things feel bad. At other times I use E45. If you find your discomfort comes back ask for a referral/hrt cream.

[knackeredoutmum]

just to say, you can test neg for thrush but still have it in a different part of your vaginal system

[notforthefainthearted]

mangledmess, sorry to hear that you're having such problems. It's hard to trust GPs when our gut instinct is telling us they're wrong, isn't it? My GP has been very sympathetic so far and I am glad she has referred me, will wait and see what the gynae is like.

Jelly, thank you so much for the tip with the vit E oil, don't know how long it will last but the pain and discomfort have gone for now, I'll keep applying it regularly and hope to get into town later to get hold of some almond oil too. I'm hoping I can find some at either Boots or Holland & Barrett.

[mangledmess]

I have alot of pain in my scar but i have several prolapses and I am sure that is the reason but I was told it wasnt possible to get pain in a scar so old, 20 years in my case. I was also told that the prolapses were not the cause of the pain either. They just about said but not n so many words that it was all in my head. I take HRT which doesnt seem to be working for hot flushes. This is my 4th kind of HRT and life is misserable. I hope you find a more sympathetic gynae than I have x

[notforthefainthearted]

Thanks Knackeredoutmum, interesting. I have been tested for thrush a couple of months ago and it came back negative. I might try that anyway if the oil doesn't help.

Jelly I agree, thought the menopause would 'just' be hot flushes and dryness, hadn't a clue about these other problems

[knackeredoutmum]

I get, obviously, stupid phone, loads of spelling mistakes

[knackeredoutmum]

You will find thus strange but i gwt discomfort, pricking and a touch if blood from my 10yr old episiotomy scar when it has become infected with thrush. For some reason the scar itseld doesnt really itch, and i do remember a very very long healing period with these particular stitches which didnt really finally feel sting and bleed free til i used canestan.

Could you try using canesten on stitches area and vagina twice a day for sux weeks? This might totally solve the problem.
Take care not ti cross contaminate by using different fingers (sorry tmi)

[Jellykat]

Wait and see what the gynae reckons first, i would..

This is a tricky bit i reckon due to the menopause, everything is out of sync mentally and physically, the list of symptoms is much bigger then i ever thought. I am hoping once its passed things may calm down a bit? Fingers crossed eh?

[notforthefainthearted]

Eek indeed! I hate going to the Dr for anything at the best of times.

I sort of thought my body would be ok til I was much older than this. This age has crept up on me, didn't even think I was old enough for the menopause until people I know of similar age started talking about it.

[Jellykat]

I dont know the answer to how would you know for sure, i would imagine it would involve a finger up the bottom by a GP < eek >

My fibroids have been good for a couple of years ta, they just sit there these days.

I alternate between Vit E and Almond oil, i only apply twice a day on average, especially after a bath as it dries your skin out.

I know the feeling about falling apart, some days i feel like that ghosty fishy captain on Pirates of the Carribean, you know the one Bill Nighy plays?

[notforthefainthearted]

Thanks Jelly.

Yes, my GP sent me for an ultrasound but they found nothing, no fibroids, no endometriosis. Hadn't thought about internal piles, how would I know? Hope your fibroids aren't causing too many problems.

How often do you apply the vit E oil?

Yeah, feels like I'm falling apart. I don't feel old enough (in my head) to feel this rough.

[Jellykat]

Blimey, you've been through the mill eh?

Yes, i would of thought your GP would suss any prolapse as there'd be bulges..

Fibroids can cause excessive bleeding, i have 2 of the little buggers, but your gynae will find them with an ultrasound.(good news is they tend to shrink during menopause as they're oestragen fed) I expect he'll also check for endometriosis, another possibility.

Are you sure you haven't got internal piles? If the pain is more to the back... Make sure you're drinking enough water, and eat plenty of fruit/fibre/veg, but i'm sure you know that. If you've got dry skin i'd also up your oil intake.

[notforthefainthearted]

Thanks Jelly, I have had an internal recently as the GP thought maybe fibroids were causing the bleeding. tbh it has been so painful since then. I presume she would know if there was a prolapse?

I have just dug out the vit E capsules and applied, maybe they were colder last time. Anyway it felt quite soothing. The scar feels a little bumpy but not as much as I expected. The pain seems to be more at the part where the anus is.

Thoroughly fed up. Have had piles and a fissure and abscess, periods from hell, all since my third child.

[Jellykat]

How about getting the almond oil (from the chemist - only about £1.80) and mixing in a tiny bit of the vit E ?

I seem to go to the GPs a lot too, and actually said to her yesterday that it must say 'barking' on my notes, but as i also said, if things keep recurring and i dont get any answers or solutions i have to keep coming back, as she pointed out they very rarely have magic answers so going back is the norm. - a lot of it is a process of elimination which takes time anyway. (i peeked at my notes when she popped out, it doesn't say barking )

So dont worry if you have to see her a bit, shes there to provide a service after all, and if she can eliminate concerns and therefore stress for you, who cares what she may or may not think.

I presume a prolapse requires a bit of an internal check? If you're squeamish you're not going to want to pop a finger up there.. also if you've not done it before you'll not know what it should feel like up there.
Dont forget i have a similar problem as you, and i dont have a prolapse.. my mum says her scar bleeds and she doesnt have a prolapse either.

It may be that they didnt stitch it terribly well last time, your gynae will know whats what.. in the meantime you need something to help short term.

[notforthefainthearted]

Sorry, forgot to say, scar feels quite bumpy I think but can't touch it at the moment.

[notforthefainthearted]

tbh I've always struggled with dryness.

Could someone tell me how I know if it is a prolapse?

[notforthefainthearted]

Thanks. Jellykat I have some vit E capsules but the content is quite thick and will hurt if I try to apply it?

I think I probably should go back to the dr but am sometimes she'll think I'm wasting her time when she's already referred me to a gynecologist and also think I'm a hypochondriac as I seem to have so much wrong with me .