DO I HAVE SCAR TISSUE?

Scar tissue can appear after an injury to the skin or tissue. To protect the fragile area the body ties strong bonds, almost like sewing thread. The area might suffer lack of blood circulation and contain blocked nerves. The result might be hard, tight and painful tissue causing pain i.e. sexual pain. 

Is the scar situated in or around the vagina intercourse might cause a sprint of pain or the sense of something being stuck? Look below at the drawings of scar tissue and consider if one of the pictures mirror your problems. 

Cause

The medical name for a scar is “fibrosis”, meaning transformation to connective tissues. Scars often appear after injuries where the skin has been cut or broken. There are plenty of ways this can happen:

Fragile skin

Your skin might be fragile either because of skin disease like lichen sclerosis, lack of estrogen, allerg. Reasons that make your skin fragile to tears. You might feel it using toilet paper, bicycling, wearing to tight jeans.

Surgery 

Women who have had pelvic surgeries will often have scar tissue where the incisions were made. Women who have had cysts, tumours, or fibroids removed may have internal scar tissue. The same goes if you have had a hysterectomy or conic section.

Childbirth 

When giving birth, some women experience tears in cervix, vulva, vagina and perineum due to vaginal delivery. Other women to help with the birth process have been manually cut open. It includes both incisions around the vagina and cuts involved with a caesarian section (C-section) surgery. C-sections result in scars not only on the belly but also inside the uterus.

Injury 

It might be a fall on a bike’s crossbar or engaging in violent sex, which inflicts breaks and scarring.

When a muscle is torn or overstretched, the body might also create scar tissue that immobilizes to stabilize the muscle.

NB: Bleedings under the skin that are not fully recovered can create inflammation and lead to scar tissue. 

Illness 

Illnesses like lichen sclerosis and bacterial infections can cause the skin to crack and bleed. When this happens, scar tissue can form if the skin is damaged severely enough. Sexually transmitted infections and endometriosis too can result in scarring.

Vaginal Stenosis 

Vaginal Stenosis is a condition where the vagina can shorten and narrow following radiation or chemotherapy treatments.  Scar tissue in the vagina can also cause adhesions where the walls of the vagina are fused.

Vaginal Dryness 

Chronic dryness not treated can result in painful sexual intercourse, that can cause enough friction in and at the entrance of the vagina to tear the skin and create scars. Read Poor Lubrication 

DIAGNOSIS

Skin scar tissue is usually apparent. The colour of the scar may be different from the not broken skin. Scars can also be shiny or wrinkly. Certain types of scars, like keloids, are often raised and obvious. Some people form lumpy scars/keloids on the pubic mound. These are keloids scars and are most common in people with dark skin. Keloids and stretch marks can even be purple or red.

Doctors can easily see and diagnose external scars. Internal scarring is harder. The scar tissue inside you cannot be seen, and therefore you do not know the exact location or the extensiveness of the scar tissue. When internal scar tissue binds tissue together, it is called an “adhesion”. These can occur anywhere inside of the body.  ( Find below pictures of internal scarring)

Within the vagina, adhesions can fuse the vagina walls or sit at the vaginal wall, between the vagina and the bowel, or between the vagina and urinary system and pull organs out of their natural place. The cervix can also become stuck in an unnatural position, making deep penetration very painful.

Vaginal scaring

Deep vaginal scaring
Scar tissue across the vaginal wall. Strings going from vaginal wall to wall. Read how to break the scarring with a dilator.

Center vaginal scaring
Scar tissue along the vaginal wall. Like little hard knots. Read how to soften the scar tissue with a dilator.

Full vaginal scaring
The vagina can fuse together and close. Read how to use a dilator

Between bowle and vagina scaring
Scar tissue placed between bowel and vagina. Pulling in the tissue during a bowel movement or deep penetration can cause pain.

Between blader and vagina scar tissue
Scar tissue situated between the bladder and the vagina. Penetration might result in pain.

Abdominal scaring endometriosis
Scar tissue in the abdomen. If the organs move as a result of penetration, this might result in pain.

The doctor or physiotherapist will be able to assess the tissue’s mobility.  Self-examinations can help you determine if there are places where you feel hard skin or tissue. X-rays, CT scans, and ultrasounds can be used if adhesions are suspected, but they do not always show the scar tissue. If adhesions are suspected in the abdomen, it might be necessary to perform a laparoscopy.

Management of scars

External scars have plenty of options for treatment. Creams,  balms and serums can be used to soften and stretch the scar tissue. Read Care of skin

You can discuss with your doctor whether certain steroids and vitamins or other could help the tissue repair and heal properly.

Manipulation of scar tissue will help better blood flow and enhance the flexibility. Irritated nerves can be desensitized.

Laser treatments might be a possibility for some types of scarring. Surgery for external scarring is very rare and generally the last option. Surgery for internal scarring is rare and typical a last option i.e. endometriosis.

For fibrosis and adhesions near the vagina, vibrators and dilators can be used. 

Seeing a women’s health physical therapist can help you identify problem areas and what to do to combat the issues. They can manipulate your tissue to become more flexible and give you exercises to do on your own. Sometimes, like with adhesions, surgery is required to cut away the problematic tissue and allow better healing. 

IF YOU THINK “YES THIS IS ME” Do Read I HAVE SCAR TISSUE

FIND INSPIRATION Care of Scar tissue  & Care of skin & The Love Bit (how to avoid sexual pain, but still have a sex life – learn from the Danes)

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