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Roy Pitkin, M.D., is a professor of obstetrics and gynecology and is the former chair of the ob/gyn department at the University of California, Los Angeles School of Medicine. He is a frequent advisor to national health agencies on women's health issues and has received numerous international honors for this work.

Q: My daughter is 6 months old and was delivered vaginally. Intercourse has been painful ever since the delivery. What could be causing this?

A: Painful intercourse after childbirth has several possible causes. Inflammation due to thinning of the vaginal lining because of low estrogen levels, especially among nursing mothers, is fairly common. The discomfort is lessened with estrogen cream or suppositories, and should clear up permanently when menstruation resumes. Another possibility is scarring from tears or other injuries during the birth process itself. These can be treated with medication or may sometimes require minor surgery. An examination by your doctor should help identify the cause.

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