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Thanks so much for getting back to me! My cause is autoimmune, a combination of things I think pelvic tightness from a connective tissue disorder, dryness from Sjogrens, as well as potentially early lichen sclerosis. Not to mention recurrent thrush from the immune suppressant medications. About 5 years ago I saw a pelvic physio and had been dilating and doing exercises and also using topical steroids and things were manageable if I also used a lot of lubrication.

However I went about a year without a sexual relationship and so I let everything except the steroids lapse and when I went back to it earlier this year I wasn’t careful enough and got a tear. I tried to get back to where was by doing an intense course of steroids and starting exercises again but now it seems like the skin is vulnerable and tears along the scar even with a small dilator.

I’m trying to be pragmatic instead of fatalistic though, I’ve booked back into the physio and have found a GP in Te Atatu who does PRP ‘O shots’ for $750. Will ask her at the consultation next week if she will inject into the scar. I’m also going to go back to the dermatologist and ask for calcineurin inhibitors as I think the steroids have stopped working.

Thanks so much for your reply, it’s heartening to know that things can get better.