Dear Jaiya,

During my pregnancy with my second child and after giving birth, I have had daily pain in the labia and vagina accompanied by dryness.  My doc has tried estrogen cream, steroid cream, and Lidocaine.  Lidocaine helps with pain, but I'm looking for a real solution. They've determined I have a dermatitis condition as well. So I have changed to hypo-allergenic cleansers and so on. Can you give me some help?  I also have pain in the uterus and cervix with spotting.  My doc suggested a hysterectomy.  What are your thoughts on this?


Thank you,



Dear S,

Oh, I have so many thoughts on this!  For the last two years my research partner, Ellen Heed, and I have spent time with women like you:  after giving birth, they experience pain.  From painful intercourse to deep pelvic pain, they have a variety of ailments such as vaginal dryness, mood swings, and dissatisfaction that accompanies this pain.  Luckily in our research we found solutions that worked for many women and may work for you too.  If I were you, I would only opt for a hysterectomy if you've exhausted all options and given it some time.  How long have you been living with this pain?


First and most, I want to ask an often overlooked question:  did you experience a tear or episiotomy during childbirth, or did you have a C-section?  What most people don't realize is that scar tissue from injuries during childbirth can cause pain, lack of ability for arousal, and vaginal dryness.


Did you do any massage to your vulva, vagina, or pelvic floor after giving birth?  Massage can help break up the scar tissue and improve pleasurable sensations, increase lubrication, and lessen pain.


Changing to a hypo-allergenic cleanser is a start, but you might also want to look into the type of fabric in which your pants and underwear are made.  There are often chemicals in the cotton and for some people that can be the cause of the dermatitis and even pain for some women.


Are you still breastfeeding?  Have you had your hormone levels tested?  An estrogen cream works for some women, but not for others.  In some cases, it can make dryness and pain worse, like it did for me.  An entire balance of hormonal therapy is most effective.  You may want to find a female hormone specialist and have them do an entire evaluation of your estrogen, progesterone, testosterone, and FSH (follicle stimulating hormone).  Due to hormonal changes, you may have a bit of vaginal thinning which could cause tiny tears which in turn could cause pain.


My biggest recommendation would be to find a specialist in postpartum sexual care.  This would be a physical therapist or sexological bodyworker who knows how to work with structural issues and scar tissue.  I am a testimony to this work as I had major scars that caused traumatic pain, inability to lubricate, and even emotional distress.