Q: I’m writing because since menopause I’ve had a lot of pain and dryness so bad I can’t have intercourse but the doc says I can slowly stretch it out again. Do you have any products that you can recommend for these 2 problems. It’s so dry and painful. I did notice that its better when it’s really hard but then it gets to a point and it’s like there is a road block of pain if it tries to go any further. Any ideas?
A: This is a great question! Now, typically when someone reports having painful sex, the first thing we recommend is that they talk to their doctor to rule out other possible causes such as such as infections, endometriosis, a partially intact hymen, vaginitis, vaginismus, etc. Fortunately, it sounds like you’ve already done this and have found out the source of the painful sex is related to menopause.
You are definitely not alone as this is very common after going through natural or even surgical menopause. The good news is, it’s treatable! The decline in estrogen production during this time can cause the vaginal tissue to thin and lose it’s normal moisture. This means you will have less vaginal lubrication and your vagina is less stretchable which can cause dryness, burning and even severe pain during penetration and intercourse. Some doctors recommend using a low dose vaginal estrogen cream or hormone replacement therapy to help. You can certainly talk to your doctor about these options.
The first thing we recommend is to moisturize your vagina and vulva tissue! You can use a daily vaginal cream or moisturizer (such as Replens or Luvena) to help maintain the moisture and flexibility of your vulva and vaginal tissues. They can be found over the counter at your local pharmacy. However, please note that these are not sexual lubricants and are not meant to be used during sexual penetration.
Next, for vaginal penetration, it’s really important to make sure you are fully aroused. Yes, this means even more foreplay and thinking sexy thoughts to help get yourself ready! We also suggest that you use plenty of sexual lubricant before and during intercourse. Any water-based lube will do! You can even do a daily vaginal massage with the sexual lubricant which can help maintain the elasticity of your genital skin and vagina.
In addition, we recommend doing daily Kegel exercises to strengthening your pelvic floor muscles. If all of this does not help, then we suggest talking to your doctor to see if vaginal dilators are appropriate. Check out one of the dilator sets we recommend here. Your doctor can give you a protocol on how to use them appropriately. Or you can seek out the help of a Board Certified Clinical Sexologist or Certified Sex Therapist in your area. They can help you with the fear/anxiety cycle that can develop as a result of painful sex and also guide you through the appropriate use of vaginal dilators, if deemed appropriate. You can find one in your area by checking out these websites: American Board of Sexology and AASECT. Hope this helps!
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