In order to prevent certain disorders such as frequent urination, chronic pelvic pain, and painful sex after childbirth, the gynecologists routinely performing an additional surgery to the surface area between the vulva and anus, and the posterior vaginal wall.
Despite the benefit of this procedure which is known as Episiotomy or Perineotomy remains conflicted for such purpose, however, some evidences showed this strategy offers better outcomes in both psychological and physical status of postpartum compared to labor without episiotomy.
In specific, this surgical procedure is performed in order to deal with unexpected incidences of following;
- excessive tension of pelvic floor muscle that normally under voluntary control,
- the tissue are stretched by the baby's head, or
- having a vaginal delivery as a whole.
In the other side, however, the postpartum may also experiences with vaginal dryness and painful sex after this procedure.
A study from Department of Woman and Child Health, Karonlinska Institutet, Stockhol, Sweden, says that, "Women who underwent episiotomy experienced a more complicated and emotionally difficult delivery. They reported a higher frequency of dyspareunia [painful sex] and insufficient lubrication than women who had given birth without episiotomy."
They concluded, "Episiotomy may affect women's sex life during the second year postpartum with more frequent pain and vaginal dryness at intercourse." (ref-1)
Despite the mechanism of relationship remains unclear, for the last decades the physicians have begun to re-evaluate the procedure because more evidences showed episiotomy contribute to more severe perineal lacerations and future pelvic floor dysfunction while the benefits of such mentioned above were lacking.
Furthermore, in the 57th annual meeting of the American College of Obstetricians and Gynecologists (ACOG) held on May 2009, a review of 10-year episiotomy during 1997 to 2006 found that there is substantial reduction in episiotomy rates across patient and many women refused episiotomy. In fact, some studies even recommended against routine episiotomy like 2005 Hartmann's study.
Overall, despite the pros and cons related to Episiotomy, this surgery still widely used in women undergo vaginal delivery, as well as the incidences of vaginal dryness and painful sex. If you are planning for birthing with vaginal delivery, you can discuss to your gynecologist whether episiotomy should be performed or not in accordance to your health status, physical factor, and the fetus condition which can be analyzed by your physician using medical ultrasonography. Final decision on your hand. Otherwise, if you already had vaginal dryness either suspected by this procedure or others related to hormonal factors, try to alleviate it with certain topical regimen containing phytoestrogen such as this recommended formula instead of conventional lubricants. This is important as you are not only want to overcome existing vaginal dryness but also rejuvenate the skin structure in the affected area where the incision performed during episiotomy. Those formula has strong estrogenic activities that promotes regeneration process of skin cells and improve the collagen and elastin levels and its composition beneath the skin due to their tannins and isoflavones content. The main active ingredients are Oak Gall and Witch Hazel and you can learn more detail about these ingredients in their pages or see the comparison of those treatment with other strategies here.
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