When I had my last children five years ago they cut my vagina, but when they put it back together it seems like I lost the feeling when I have sex. Now it is really difficult for me to have an orgasm. I don't feel anything. Help, please!

T.

I am assuming you mean you had an episiotomy with the birth of your last child (or was it twins?). An episiotomy is a small cut between the vagina and the rectum, made to enlarge the vaginal opening and facilitate childbirth if the tissues are not supple enough to stretch on their own -- or if the baby is just too darn big! Most of the time, an episiotomy is made straight down, but rarely a mediolateral episiotomy is done; a mediolateral episiotomy starts in the middle of the vaginal opening but heads off to one side or the other. This type is more painful and may not heal as well, leading to pain with sex.

When an episiotomy heals, there may be scar tissue underneath it that is either without sensation or, more commonly, hypersensitive. While vaginal and perineal pain after an episiotomy is almost universal for several days or weeks, because this area heals so well, long-lasting pain is very uncommon. The lack of feeling you describe sounds more like that associated with everything stretching out so much during childbirth. The vagina can be much more lax, and roomier, after giving birth. Because it is not as tight, the penis may not provide as much stimulation during sex; both partners may notice this decrease in pleasurable friction.

You should discuss your problem with your gynecologist. You will need to be open and explicit in describing what you are feeling -- or more accurately, not feeling. She may need to do an exam to visualize what you are describing. If the problem is due to pain from scarring under the episiotomy, then steroid and local anesthetic injection may help. If the problem is a too-roomy vagina, then surgery to tighten the vaginal opening and correct any relaxation of vaginal walls may be the answer.