Painful Intercourse Postpartum, Hemorrhoids: What can I do?

I have a 3 1/2 month old baby boy. My husband has been very patient with me regarding sex. However, just recently we have been trying to have intercourse but have not been successful at it. My problem is that I am experiencing a lot of pain in the vaginal area. It's not dry but it feels very hard, tight, and there's a burning sensation. I am very scared that the Doctor may have done something wrong regarding stitching the cut from the episiotomy. Please let me know if this is normal and what I can do about it. I am becoming more and more afraid whenever we try to have sex.

Lately, I have been suffering from hemorrhoids. I have tried practically everything including prune juice but nothing seems to be working. I was wondering if you can tell me what foods lead to constipation. I suspect that I am eating a lot of these foods.


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

Dear Manal,

At 14 weeks postpartum, it is normal to still be experiencing some discomfort especially with entry but you should not be having true pain. So much here depends upon if you are breastfeeding, if you are using any birth control method, if you had a traumatic birth experience, 3rd or 4th degree laceration, infection, complications.

When you returned for your 4-6 week check, your provider would have noted if healing was not proceeding as expected. My guess is that it just needs more time. There probably has been a build up of scar tissue which needs to stretch out again.

Massage the area daily with olive oil or vit E oil (break the little clear pills open) or use Arnica oil from the health stores. Use a lot of lubrication with intercourse (Astroglide is great or a product called "slippery stuff"). K-Y jelly works also.

Tenseness before intercourse can decrease lubrication and cause the muscles to tense, so plan for a time when you can relax. Take a warm bath before love making.

This will most likely resolve but may take up to 6 mo to a year to be totally comfortable.

If you did not make your 6 week check up, or even if you did, I would not hesitate to see your doctor or another provider for another exam.

I wish you the best with this and there is hope.

Regarding the constipation, most breastfeeding mothers do not get enough fluids. You should be drinking an 8 oz glass of water each time you nurse. If you are not nursing, drink a lot anyway. You should stay away from refined sugar and cheese but most important you should eat 5-8 servings every day of fruits and vegetables and 5-6 servings of bread and grains (whole grains are best). Get some unprocessed bran at the coop or health store and add it to your cereal in the morning.

You may take a bulk former such as metamucil also which is helpful to get things going. Exercise is critical to this situation also. Make sure you are walking 20-30 minutes every day at an aerobic pace.

If the hemorrhoids are external, push them back in after each trip to the bathroom and then stand up and do a "Kegel" exercise (tighten your perineal muscles). This holds them inside where there is more room and they don't get strangulated and engorged with blood. A trip to a surgeon might be in order if these are really troubling.

I wish you the best with these issues and let us know how you are doing.


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