Ruth, 51

I started trying to avoid sex and that fuelled Lawrence’s suspicions. He thought I was having an affair

But it stems from the fact that I had an episiotomy when I was in labour with my daughter, which means the doctor made an incision in my vagina to make it easier for me to give birth. When Lawrence and I started having tentative sex about 12 weeks after our baby was born, penetration caused me terrible pain. My midwife implied I was being hysterical and making the pain up.

Lawrence is a deeply caring partner but as the months went on he started to worry I was making the pain up, too. The doctors were so insistent that I had healed perfectly that Lawrence started to suspect I didn’t desire him any more. It felt useless to keep talking about the pain when no one believed me, so I started trying to avoid sex. I would come home late from work, or say I was too tired.

Lawrence might have doubted me, but he never stopped researching my symptoms online and about seven years after our daughter was born, he tracked down a specialist. She took one look at my scar and said I needed an operation called the Fenton’s procedure because the cut had not properly healed. It was the most incredible relief.

The operation was successful but I’d be lying if I said our sex life has fully recovered. It’s been 15 years since I felt pain during sex, but I still tense up before penetration. Lawrence wants to have sex every day like we did before our daughter was born, but my libido is lower. Because sex has always been such a tense topic between us, it’s difficult for me to turn Lawrence down without hurting his feelings.

Since menopause, my libido has dropped even lower. Part of our issue is that when Lawrence feels rejected he spends less time wooing me, so it’s a vicious cycle: I want sex less and less. On the upside, I feel stronger in myself since hitting my 50s and I’ve got better at communicating about sex. I don’t want to say yes just to keep Lawrence happy. I want to be true to myself.

Lawrence, 51

We’ve become much more playful and relaxed about intimacy since Ruth’s operation

Before we had our daughter, Ruth and I had sex about five days a week. I wasn’t expecting our sex life to continue at that rate for ever but I wasn’t prepared for what happened; after our child was born we didn’t have connected, satisfying sex for seven years.

After the episiotomy, any time Ruth and I tried to be intimate, she said it felt like an internal friction burn. We tried extensive foreplay and avoiding penetration, but often Ruth would want to stop in the middle of that because she feared pain.

The doctors repeatedly told Ruth there was nothing physically the matter with her, so I did start to assume the problem was psychological. Ruth’s mother used to tell her that women aren’t really interested in sex: they only do it to have children. As the years wore on and Ruth kept avoiding sex, her mother’s words would circle around my mind. I felt Ruth had got what she wanted out of me and now I was no use to her. I also went through periods of losing trust in her. I thought she might be getting sex from someone else.

Sex did improve after Ruth had the Fenton’s procedure. The psychological scars are still with her but sex is no longer a constant source of tension between us. My testosterone levels have also gone down a little. I often think sex works a bit like airbrushing in a relationship: if the sex is going well, other small irritations don’t bother you so much. If it’s not, they come to the surface.

We are more playful and relaxed about intimacy again now. Ruth often reads erotica when we are in bed, and we talk about our desires freely. But because of what we went through, I sometimes think there’ll always be an issue with sex.