Intimacy was so painful last time that I dread having it again, so I’ve been avoiding it.
I understand. Once intercourse has become painful, there’s not much reason to look forward to it. But if you don’t address it, you’ll have intercourse less and less often, and eventually maybe not at all. This is not something that will get better on its own.
Fortunately, vaginal dryness is almost always treatable. You don’t have to suffer! But you may need to be patient and determined. In spite of the evidence that shows that most menopausal women experience vaginal dryness, there are medical practitioners who will tell you it’s all in your head and/or there’s nothing that can be done about it. If you’re not entirely confident in your doctor, seek out a menopause care provider before you start down this path.
Once you do find a practitioner who is knowledgeable about the issues that come with menopause, you’ll still need to be persistent while you try out treatments until you find one that works for you. That can take some experimentation—three months is commonly how long it takes to thoroughly test-drive a treatment regimen. I think you’ll find that pain-free sex is worth the inconvenience.
Start with the basics. Avoid using scents, harsh soaps, douches, non-breathable underwear, all of which can irritate your bottom. Then, use lubricants liberally during sex and use a moisturizer regularly.
If this vaginal-care regimen doesn’t do the trick, another option is topical estrogen. Many women are hesitant to use a hormonal product, but the American College of Obstetricians and Gynecologists (ACOG) reaffirms that estrogen used topically in the vagina can offer significant relief without being absorbed systemically. So it’s safe, even for breast-cancer survivors.
Another option is the new drug Osphena, which acts like estrogen—without being an estrogen—to vaginal tissue; it has no effect on other tissues. (This is called an estrogen agonist/antagonist.) So it’s also safe for those with breast cancer risks.
There’s also a relatively new product called Intrarosa, a vaginal insert used daily. Both of these are by prescription, so another discussion with your doctor is in order. And neither focuses specifically on the vulva, but typically what helps the vagina also helps the vulva.
Finally, an important way to keep vaginal tissue healthy is sex itself! Once you can tolerate a little sex, you’re on the way to enjoying a lot more.