WOMENS-HEALTH Messages for April, 2003: Re: perineal tearing 13 years postpartum

Re: perineal tearing 13 years postpartum

From: Richard Chudacoff, MD (anonymous@obgyn.net)
Sun, 20 Apr 2003 22:07:56 -0500 (CDT)

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In reply to: Heather: "perineal tearing 13 years postpartum"

At Sun, 20 Apr 2003, Heather wrote: >
>I have ascar from repair of a tear in the perinium that occured when my
>child was born 13 years ago. 9 years ago I was treated for CA Cervix
>with radiation. While the top of the vagina was irradiated, the lower
>2/3 was not. Nevertheless, my ovaries were irradiated, and I
>consequently entered menopause earlier than normal. I amnot taking HRT.
>Over the years, I have experienced increasing trouble -- pain,
>recurring small tears around the scar with even the slightest pressure,
>friable labial tissues. Sex is no fun b/c it results in numerous tiny
>tears that take a long time (7-10 days) to heal and are painful. I can't
>even masturbate anymore. My MD recomended premarin cream to the perineal
>/ labial tissues, and promised that it would help to 'toughen up' the
>tissue, but after 7 months, there is no improvement, and in fact, things
>may be worse. The scar is getting whiter and toughter and the areas
>beside the scar are more friable. I'm only in my mid-40s. The thought
>of not having sex for the next 40 years ain't much fun. What are my
>options? Is there a different remedy or procedure than just using
>topical estrogen? I'm feeling pretty desperate!
>
>Lesley

My recommendation would be to take oral estrogen for 4-5 months, then go in surgically to remove the scar tissue, and while healing use both oral and topical estrogen. This may help. Another option would be injection of the area with a combination of steriods and anesthestic like Marcaine, and continued use of estrogen cream. You may not be able to rectify this situation completely, but some help is probably better than none.

-- Richard Chudacoff, MD, FACOG Chudacoff Obstetrics & Gynecology, PLLC Sugar Land, TX

Note: opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship. This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private emails cannot be entertained due to time constraints; consequently, they will receive no response.

**Thank you for understanding :).**********************************************************************

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