Aunt Vadge: fissuring that just won’t go away

Vaginal fissuring that won't go away

Vaginal fissuring that won't go awayHi Aunt Vadge,

I am becoming very frustrated and need some advice please! I have a fissure/cut below the opening of my vagina that keeps reopening. I have had scarring for a few years but a few months ago after sex with my partner, a painful cut appeared. I phoned my doctor and was told to wait a while before having sex, keep it clean, etc. We waited three weeks, as it seemed to be healed. It reopened even though we had used plenty of lube and took it slow. 

We then waited six weeks. The scar was there but it all looked good. We had sex and it didn’t open, woo hoo! We waited a few days and did it again… but this time the fissure came back! Why is this happening? 

My fiancé and I have been together for two years, and it started up after one year this time, but this started a couple of years ago with another partner. It started happening again when I moved in with my partner and was quite stressed.

When it started happening, I also started getting a strange feeling/cramping after sex occasionally. It’s hard to explain, but after he pulled out, I would feel pain in my stomach. I would feel sick, dizzy, and like I needed to empty my bowels, which lasted about five minutes and then I would feel fine. The doctor told me that my partner was hitting my cervix and I possibly had a vasovagal reaction. We changed positions and he didn’t go as deep, and we haven’t had this issue since. I was told I had a tilted cervix, so we have had to find a position that was comfortable. 

I was in a relationship for five years prior to this, without issue, but his penis bent to the side a bit more, so may have fitted with me a little easier! This did make me worried about sex, however, and I would tense up. Before these fissures, I have always enjoyed a good sex life. We used to have LOADS (up to four times a day) without any fissuring. I was told I had scarring in a smear test a couple of years ago.

I must also mention that I had quite rough sex with my previous partner about a year before my current partner, and bled quite badly. I thought this was the start of it, but after going to the doctors the day after, they advised this must have been from him hitting my cervix, because I wasn’t cut. It was quite a lot of blood though, so it seems strange it wasn’t from a cut. 

The cut is about half an inch long, maybe bigger, right in the middle underneath the opening of my vagina, inside of me. It bleeds a bit after sex, but not much. We use natural lubes. I don’t have any skin conditions, but I am on antidepressants (Citalopram) and the pill (Millinette 30/75). I am also on the pill, and have been since I was 16, though I changed brand last year. I don’t eat a lot of meat, but enjoy my fruit and veges, cooking from scratch most days. I’ve been craving a lot more sugar recently, which I think is due to stress. I used to get thrush quite often but haven’t had it for a while.

My partner is also quite prone to thrush. My fiancé is very patient but this has definitely been affecting our intimacy. We are a couple who used to very much enjoy sex. I now worry every time that it’s going to be painful. The feeling after of seeing the scar reopen is so frustrating. I have spoken to the doctor about this. I was given Fucibet cream (betamethasone, fusidic acid) but this just stings and doesn’t seem to help it heal any quicker. Also It says on the booklet that this shouldn’t be used inside the vagina. The cut is kind of inside the vagina so I stopped using it. 

What can I do to help it? Will I ever have sex without this happening again? I am getting very upset after sex due to the frustration of it, and I am someone who very much enjoys sex and doesn’t want it to be painful. Thanks in advance.

 Very grateful for your help! 

Best,
Frustrated
Age: 28
Country/Area: UK

Dear Frustrated,

The old mystery tear, huh! It sounds extremely uncomfortable and very frustrating indeed. Here are some ideas.

Musculoskeletal

Have you ever seen a pelvic physiotherapist or an osteopath that specialises in the pelvis/gynaecological osteopathy? You seem to have a bit going on in your pelvis, and it might pay to book an appointment with one of the very best, and see what they can find out with a proper pelvic examination – there are so many muscles, ligaments and tendons that hold our pelvis in place, and it’s possible that your vaginal canal/cervix/uterus are sitting in an odd position, which could cause your partner’s large penis (which doesn’t help matters) to push on the wrong area of your vagina, where you are tearing.

This would be the first thing to do – at least to have someone who knows pelvises inside out (literally!) to actually physically examine you. Because it’s a physical thing happening, like mechanical of sorts (only with sex, only in a particular place, repetitive – like RSI in your vag!), and not something that is occurring throughout your body – that is, if it was like a skin condition and you were seeing signs in other places on your body, then that would be a clue. If it was cyclic, that would be a clue. You have a puzzle to work out!

Pelvic physios look at the weirdest stuff all day long, and have vast networks of colleagues who specialise in the same area to ask about hard cases – they have seen everything. They can also talk you through the yeast possibilities, or the pill, or meds. They truly see the hardest cases of all kinds of stuff and will have a much broader experience than a gynaecologist or GP. They are also not doctors, so they approach problems differently, and have a different toolkit for solutions.

Protein deficiency

If you don’t eat a lot of protein (meat), you may find you have other symptoms like flaky or weak fingernails, wounds slow to heal (or in your vagina’s case, wounds that open easily), and stuff like that – anything that requires protein to be strong, which is all human flesh and nails and hair.

You may also find that your brain isn’t quite working as you want it to, because you require protein (amino acids) to make neurotransmitters, which are the things that make you feel good and able to respond. If you’re low in neurotransmitters, because you are low in amino acids, you can end up with anxiety and other minor but mysterious mental issues. Have a fist-sized portion of protein with every meal, which doesn’t have to be meat, but it could be egg, tofu, tempeh, beans, chickpeas, lentils, nuts, seeds, and so on. Meat is good too.

If you don’t eat much meat generally, you may find that you are low in iron too, which can result in heavy periods (paradoxically), feeling tired, and thinking and feeling problems. I can’t stress enough how important enough protein is for your whole body function, including your vagina. Meat has a lot of zinc in it too, so maybe you could use a bit of a check-up for your diet? Do any of those symptoms ring any bells?

Medication

The effects of medication on our bodies cannot be underestimated with niggling issues like this. Obviously your anti-depressants and the pill are both important parts of your health in various ways, so I understand making changes to them isn’t necessarily on the menu. You don’t say how long you have been on antidepressants for, but they are famous for drying us up, and also causing strange issues that seem unrelated.

The pill is also another major culprit of mysterious niggles. It’s really hard to know if it’s either of those meds (or both!) without going off them. If you felt like you were up for it, it can be useful to go off the pill and see how your body behaves off it – you have been on it for a very long time.

My favourite birth control is the non-hormonal IUD, as you get to keep your natural cycle, but no babies, if you were looking for an alternative. The pill has a lot not to like about it, including that it kills good bacteria on contact, and will make you far more prone to yeast infections.

Yeast infections

You mention quite a lot of yeast infections between you and your partner – can you tell me a bit more about this? Do you know why you are both prone to yeast infections, and who seems to get it first? (They spread) I’m just wondering if a deeper yeast infection could cause this – there are sorts of yeast that grow roots and invade tissue.

These yeasts don’t always appear on tests, since a test is usually a swab, and doesn’t get deeper into the tissue. If you and your partner are both prone to yeast infections, it might be useful to put you both on a biofilm treatment to get rid of them once and for all.

Yeast blooms almost always come from the gut, and yeast create biofilms which stick to your cells, blocking other healthy microbes, and making it really easy for flare-ups to occur. There are a few really good options for removing yeast gut and vaginal biofilms if you were interested in investigating that further.

What to do in the interim

The best thing for you is to avoid splitting it again, obviously, but in terms of healing, keep your zinc levels up, lots of protein – things that keep our flesh (meat, essentially) strong, and help it heal fast with as little scarring as possible. Not sure what your diet is like, but making sure you have everything you need to heal fast and well is key.

You could also find a local herbalist or naturopath to make you up a healing supportive suppository until you can get the help you need to find the root cause. You could also make up your own if you were so inclined – they are pretty easy to make. You could make an easy one with coconut oil and soothing, healing-promoting essential oils. I’d say that suppositories with liquid herbal extracts would be better though if it was an option. Oils are good though, just very low dose. Coconut can be quite nice too. Here is a list of some oils you can try with instructions in the link for the suppository recipe.

Write anytime!

Warmest regards,
Aunt Vadge

 

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.