My doctor
>said there was no infection; I was just experiencing early lactational
>atrophy due to
> lower levels of estrogen. Not only does this atrophy account for decreased
>lubrication, it also makes the tissue of the vulva more irritable, and, my
>clitoris has almost disappeared.

I haven't heard the phrase "lactational atrophy" - we describe vaginal
atrophy in some post-menopausal women, and similar atrophy in some lactating
women. However, it seems unlikely that "atrophy" would be obvious one week
after delivery - her oestrogen levels were high one week earlier. It may
seem to her that her clitoris has changed - but this may have occurred
anyway once her pregnancy hormones have decreased.
Breastfeeding women should be encouraged to use vaginal lubrication (this
has been discussed in the past) as natural vaginal lubrication is decreased
in lactation. And occasionally, they may need to use topical oestrogen (eg
intercourse still painful despite additional lubrication) - but most women
are happy to put up with some discomfort when they realise that there is an
explanation for this.
Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

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