I’d like to address the impact that Episiotomies can have on women, particularly in the way of sexual dysfunction. I unfortunately have experienced this first hand, and am very passionate about making sure women are informed about how this ‘small cut’ can impact their relationship with self and with their partner.

As previously mentioned in my blog about Episiotomies (which you can read here), Vaginismus is a condition where the muscles in the vagina tighten involuntarily, and often is associated with trauma. Not unlike birth, sex and intimacy has a LOT to do with the mind, especially for women. Women generally take a lot longer to become aroused and for their body to relax and allow for intercourse; we need a lot more mental arousal – it’s just in our biology!

Now for the woman who has experienced trauma, particularly related to the vagina, be it from childbirth or from sexual assault, whether she’s consciously thinking about her experience/s or not, her sub-conscious mind and her body still remembers and replays those memories, which can present as Vaginismus.

When women (who suffer from Vaginismus) engage in intimacy with their partner (or themselves) their subconscious goes straight back to that moment (again, they’re probably not consciously thinking about the event), causing the vaginal muscles to tighten, often to the point where penetration is virtually impossible, causing a lot of pain! So as you can see we have what is termed as a ‘negative feedback loop’ (i.e. the brain automatically assumes sex = pain); something I learned after having to undertake some sex therapy sessions after the birth of my firstborn who I had an episiotomy with.

To quickly summarise my learnings in the sessions I had, I’ll say that we were completely banned from having touch and intercourse until *I* had established a new POSITIVE feedback loop (which happens as a direct result of the release of Oxytocin), which essentially meant I had to get comfortable with my own body again before I shared intimacy with my husband. I do to the work in order to get my brain to associate sex with pleasure instead of pain.

If you feel you may be suffering from Vaginismus, I strongly suggest seeing a sex therapist! I know it’s incredibly daunting and feels a bit embarrassing, but honestly there is no shame in seeking help with something that is incredibly important in your relationship with self and your partner (if applicable).

In the meantime,  you could try using vaginal dilators such as these or depending on the severity of your condition, you can find another toy that is roughly the same size as your partner, and work up to full penetration, in your own time and without any stress.


  • Oxytocin is the key to creating a new positive feedback loop; just like in labour, you want all your muscles to be nice and relaxed and you want your body to have the chance to produce its own lubrication (it also helps to use a commercial lubricant – water based is the best).
  • If you are going to go on this journey, please get your partner (if applicable) on the same page, and let them know you will tell them when YOU’RE ready for intimacy again and that you don’t want to feel ANY pressure or be guilted into it.
  • Take it SLOW; start very basic with just light touch externally and eventually when you’re feeling comfortable work your way up to the full insertion [this could take days, weeks, months etc. – every BODY is different!]
  • It really is true when they say absence makes the heart grow fonder; or in this case….. celibacy?…

I hope you found this information helpful!





Hi my name is Sammi Papadam, and I am a birth and postpartum doula! I have worked with women and newborns for many years in the nursing industry until recently when I pivoted in my career to actually ‘be with’ and work ‘for women’ as a doula  as this is something I wasn’t able to do properly as a nurse due to time constraints etc. I have completed training with Julia Jones from Newborn Mothers and am undergoing training Vicki Hobbs from the Doula Training Academy, as I wanted to gain a deeper understanding of birth physiology and postpartum care for newborn families. I’m also a qualified First Aid Trainer and Assessor and offer this unique offering in most of my packages.

If you would like to talk more about your birthing options, or First Aid training, please book a consultation with me below.