Here are questions from readers that were addressed by a leading obstetrician and gynaecologist Dr Mini Salunkhe. The identities of the solution-seekers have been withheld to protect their privacy.
Dear Doctor, sex is always very painful for me. What can I do to make it less painful and more pleasurable?
Pain during sexual intercourse could be due to many reasons; Some common reasons are vaginal dryness caused by vaginal infections, ingestion of oral contraceptive pills for a long time or anti-allergy pills. If there is a lack of lubrication leading to vaginal dryness, you could try some water-based lubricant before contact. However, vaginal infections if any will need to be examined and treated by your gynaecologist. Vaginismus is also a common condition in which there is an involuntary spasm of the vaginal muscles due to the fear of being hurt. In such cases, sexual therapy may be helpful. Some woman may even opt to use yoni eggs that actually work to help strengthen the vaginal muscle. Basically, anything that helps with destressing and relaxation is helpful for pleasurable and pain-free sex.
I am 45 years’ old and have been going through severe hot flushes. Is there any way to deal with this? Also, I would like to know what causes it?
Hot flushes are a frequent symptom of menopause and pre-menopause, that is,a few years before menopause. It’s really difficult to avoid hot flushes but you can decrease the severity by avoiding certain triggering factors such as stress, caffeine, alcohol, smoking, spicy food, exposure to high temperatures, etc. Some simple measures to help relieve hot flushes include staying cool, wearing loose clothing, daily exercise like swimming, walking and natural stressbusters like deep breathing exercises and meditation. In the case of menopause your doctor may prescribe short courses of Hormone Replacement Therapy. For better understanding, it would be advisable for you to chat with your gynaecologist and get a complete brief on the pros and cons of such therapy. Let me assure you that it is quite effective and safe to use for a short-term period.
Dear Doctor, I am five months pregnant. Is it safe for me to continue having sex with my partner? What all precautions should we be taking as the baby bump gets bigger?
Yes, it is safe to have sex in a normal low-risk pregnancy. However, in certain conditions like low placenta, history of previous miscarriages, leak of amniotic fluid, vaginal infections or other medical/ obstetric problems complicating pregnancy, it would be wise to abstain from sex till your gynaecologist/ Sydney obstetrician tells you otherwise. Either way, your doctor will guide you on necessary precautions depending on your overall condition. It’s also important to let your partner know if you feel uncomfortable in any particular position or any kind of sexual activity. You may have to experiment a bit to find a particular position which is comfortable for you as the baby bump gets bigger. You could place a wedge or pillow below your back to tilt it, so that you aren’t flat on your back during love making. It is advisable that your partner supports himself so that his entire weight is not resting directly on your abdomen.
Doctor, I am just a month pregnant. Yesterday, I met a friend who just gave birth by a normal delivery. She told me that the doctors made an incision on her vagina to make the passage wider for the baby to come out during labour. Can you please tell me if making an incision is safe?
This incision you are referring to is given during normal delivery between the vagina and anus. It is called Episiotomy. This is given when the head of the baby is crowning at the perineum. The incision is given to expand the vaginal area and to prevent irregular tears of the vagina extending into the anal area and surrounding pelvic area. Episiotomy is a clean cut, which is safe and necessary at most times for a smooth delivery. As I mentioned, it is to prevent possible injury to the surrounding pelvic, anal and urinary areas. Your doctor will give you an Episiotomy only as big as that is required which will depend on the weight of your baby and the vaginal area. You can be rest assured that this is quite normal and there is no reason to fear or worry about this.
Thank you, readers for your queries. I hope I have been able to answer them and clarify your doubts. I would be more than happy to take time off to answer all your questions week after week. You can reach me via editorial@pune365.com
Dr Mini Salunkhe is a senior gynaecologist practising in Pune for over a decade. Apart from being a private practitioner, she is a consulting obstetrician and gynaecologist at Inamdar Hospital.
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