The joy of motherhood is also accompanied by morphological and physiological changes. During pregnancy and after childbirth, women's bodies change. The perineum, a group of muscles located between the pubis and the spine, is very much in demand during pregnancy. This area - also known as the pelvic floor - undergoes a natural relaxation linked to the passage of the baby. When perineal re-education is not enough to remedy the problem, other treatments may be considered. Another common problem is a painful episiotomy scar, with the pain intensifying during intercourse. What can be done about it? What can medicine do to alleviate the consequences of post-pregnancy?
The perineum - also known as the pelvic floor - is an interlocking set of muscles, tissues and ligaments that form a hammock-like structure in the pelvis, between the pubis and the coccyx. The perineum plays a decisive role in supporting the organs of the abdominal cavity, mainly the viscera, bladder and uterus. Its suppleness and tone determine the body's urinary and faecal continence. The origin of the word "perineum" is suggestive, since it comes from the Latin "perineum" and the Greek "perineos", which mean "around the evacuatory passages".
Motherhood puts the perineum to a severe test. During pregnancy, the perineum must withstand the constant weight of the baby and the placenta. During vaginal delivery, the perineum is spread to allow the baby to pass through, and may be cut (episiotomy) to prevent tearing.
Le perineum after childbirth is not the same as it used to be. Pregnancy and childbirth lead to relaxation of the perineum. Distended, less toned, it can no longer perform its functions properly. As a result urine loss These include uncontrollable movements when under stress (carrying a heavy load) or coughing, leakage of vaginal gas, faecal incontinence, or a lack of sensation during penetration. Relaxation of the perineum requires specific treatment through perineal re-education, to avoid more serious effects such as genital prolapse. Gynaecologists, midwives and physiotherapists help women to re-educate their perineum, which involves several sessions of targeted exercises. Resuming sport should not be done without the green light from these specialists.
Once perineal re-education has been completed, if the problem of relaxation persists and depending on the diagnosis, it is possible to have recourse to vaginoplasty procedure. This non-surgical procedure involves narrowing the vaginal canal using hyaluronic acid injections or a laser. In some cases, medical vaginoplasty can reduce the urinary and sexual discomfort caused by the relaxation of the perineum.
After pregnancy, there's no rush to resume sexual relations. Listening to yourself, talking it over with your partner, feeling your sexual desire returning... these are the right reflexes to get back to fulfilling sexuality with this very different body. However, pregnancy and childbirth can sometimes have led to physiological changes, hindering sexual pleasure. The ability to contract the perineum during intercourse amplifies sensations and intensifies pleasure. Conversely, relaxation of the perineum sometimes significantly attenuates the feminine experience. Vaginoplasty can remedy this.
If you have had an episiotomy (an incision made in the perineum to make it easier for the baby to pass through and to avoid the risk of tearing), the scarring may cause pain, which is amplified during penetration. It is essential to wait at least several weeks and the supposed end of healing before considering vaginal penetration. But in some cases, the pain can be long-lasting. The reason for this? The healing process can lead to adhesions at the stitches inside the vagina.
These pains can be treated with specific physiotherapy sessions, but also with a medical procedure. After a thorough gynaecological examination and depending on the diagnosis, hyaluronic acid injections or laser treatment can help restore elasticity and thickness to the vaginal mucosa and stimulate natural lubrication. In some cases, these techniques can be used to help treat dyspareunia (chronic pain during sexual intercourse) and vaginal dryness.
Pregnancy can change the volume and shape of the labia majora of the vulva. Some women resort to a specific procedure aimed at reducing the size and shape of the labia majora.labia majora augmentation.
Article written by Dr Romano Valeria
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