My wife and I tried to have sex for the

Patient

Q: My wife and I tried to have sex for the first time here in Istanbul 48 hours ago from this email. She has never had sex before. I barely entered her and there was instantly a lot of blood lots!!!! so we stopped and panicked. She said she almost passed out from the pain.

That night we read that bleeding was normal but our case seemed extreme so we went to the hospital (34 hours later) and saw a doctor that barely spoke English. Looked at her and said he saw a tear or something and she needed to rest and if the bleeding didn't stop come back in a few hours and she'd have to go under general anesthesia for him to look inside. I don't think he understands that the blood was instant or us for that matter so I'm reaching out to you to see what she needs and if in the morning she should come see you. She doesn't know I'm asking, she's already worried enough.

Today, this morning she had a little spotting and it seemed like nothing but when we went out she felt very weak so we spent most of the day in with very little walking. Still spotting very little but barely anything. She seems not able to walk more than a few blocks without irritating herself.

My first question is obviously should we come in? Does she need to be checked right away? Should she have antibiotics?

I'm freaking out and feel terrible. We obviously were not prepared for such a traumatic experience and obviously unprepared.

She's 28.

Okay that's all I can think of. Please write back.

Doctor

A:   Hi young man.
Thanks for an elucidate self-explanatory history.
This happens in every girl's life.
Exactly the same way it happened with your wife.
There is a membrane over the opening of hte private part (vagina)called hymen and it ruptures on the first insertion of penis.
In some the hymen can be just a very thin membrane and on rupturing fo the first time, it bleed some and usually heals within 3 days.
In some this can be a thick membrane with lots of bleeding on first intercourse and then can take more time. Since your wife is 28 years and experience the pain and tear for the first time, it must have been very traumatic to her because possibly the membrane(hymen)was thick. So it takes a few more days for the healing to occur.
Till then she should be involved in sex and take full rest. Walking will definitely cause a problem at the raw wound. Watch for 48 hours more if there is positive progress with less pain and irritation and stoppage of the spotting.
Discuss with her before trying the next intercourse and do it only when when is fully prepared mentally.

If the Gynecologist is available it is better to check for a few reason:
Gynecologist can check for the thickness of the hymen, the nature and extent of the tear and if required a stitch can be taken if there is a large wound, and most importantly, if the hymen is very thick and still not completely tore, can be surgically corrected for the safe and enjoyable future for both of you.
- There obviously will be counselling done by the most experienced person dealing with such situations and can help your wife to recover faster.

I hope this answer helps you.
Please feel free to ask further relevant queries if you have or if you feel that there is a gap-of-communication .

Comments / Follow Ups

Patient: A gynecologist did see her at the hospital but didn't want to check deep as it's cause pain to the tear.

Again I want to ask if she needs antibiotics?. Is an infection possible.?

We were prepared and knew it'd be painful but didn't expect so much blood. I stopped instantly. I've read up on it now which we should have done before. It was traumatic for both of us!!!

Thanks again! You've been a great help!!
Doctor: Yes, it is better to take antibiotics as infection is possible and anti-inflammatory like Ibuprofen too.
Locally to the exterior she can apply liquid povidone iodine just to keep the area sterile.
Yes, it is possible that the pain may not be allowing the internal examination.

Take care .
Patient: This morning there was a clear and pinkish liquid when she checked. Does that sound like infection?
Doctor: Clear pinkish fluid is not infected, it is like a normal fluid out of blood called serous fluid. Not much to worry.

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