Vaginal dryness, irritation and soreness are common symptoms of menopause which affect different women to varying degrees.
During and after menopause, estrogen levels continue to fall gradually until they stabilize at a new lower level. This means that vaginal dryness is usually not experienced until several years after menopause. The vaginal tissue depends on estrogen to keep it moist and healthy. In the absence of estrogen:
- the vaginal lining (mucosa) becomes thin and easily injured leading to soreness and burning
- the mucus glands which help with lubrication decrease in number leading to slow and poor lubrication when you are sexually excited leading to vaginal dryness
- there is reduction in vaginal blood supply and the vagina shrinks (this is called vaginal atrophy). This causes small wounds which occur during intercourse to heal very slowly because of poor supply of nutrients from the blood leading to vaginal soreness during and after intercourse
- the vagina becomes less acidic so you become more prone to bacterial and yeast infections
- the vulva (the area surrounding the entrance to the vagina) is usually involved in these changes and may become thin, dry and cracked
The result – having sex becomes a nightmare! Your partner may not understand what you’re going through unless you tell him. It will cause less of a strain on your relationship if you explain that that your reluctance to have intercourse is not his fault but because of the vaginal dryness you’re having. So, does this mean you have to give up intercourse? Definitely not! There are various strategies you can use to improve vaginal moisture and lubrication and reduce the discomfort of intercourse.
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- “Use it or lose it!” – As with many other things in life this also applies to your vagina. Having vaginal intercourse once or twice a week will help your vagina stay moist and healthy and reduce the symptoms of vaginal atrophy. You will also lubricate faster when you’re aroused.
- Use a bioidentical, natural estrogen vaginal cream. This has a direct effect on the tissues of the vulva and vagina and restores moisture over several weeks. Use 1/4 teaspoon of cream inserted into the vagina and applied to the vulva 3-4 times a week. It may take up to 4 weeks for you to notice any improvement in vaginal moisture. If you are applying a bioidentical progesterone cream or progesterone/estrogen combination cream to your skin, you may also notice an improvement in vaginal symptoms.
- Keep a lubricant handy – A water-based lubricant should be close to your bed in a drawer or night stand. This will make sex more comfortable while you work on naturally increasing vaginal moisture. It will also relieve anxiety about painful intercourse which can kill your urge for sex.Avoid using oily lubricants like baby oil and petroleum jelly which are not healthy for the vagina and are difficult for the body to remove. Some good ones include Astroglide, Wet and K-Y .
- Can Replens and other vaginal moisturizers cure a dry vagina (vaginal atrophy)? Replens, Astroglide and K-Y are well known vaginal moisturizers with long-lasting effects. A single application can last up to 72 hours. They have also been shown to increase the acidity of the vagina making it less prone to infection and also increases vaginal secretions. They may seem a little bit expensive compared to ordinary lubricants, but you may find that they are worth it.
- Fish oil for vaginal dryness – Take lots of essential fatty acids (EFA). These include:
- Omega-3 (fish and flaxseed oil ),
- Omega-6 (evening primrose oil and borage oil) and
- Omega-9 (olive oil).
They help to keep the vagina healthy and also help your body produce hormones. The best source of these fatty acids is oily fish like fresh salmon. Others are tuna, mackerel and halibut. If you can’t eat enough fish to get a good supply of these EFAs take a good supplement with a combination of all these fatty acids .
- Vitamin E – the natural form of Vitamin E (d-alpha tocopherol) rather than the synthetic form (dl-alpha tocopherol) can be very useful for vaginal dryness. Puncture one capsule and insert it into the vagina. You can do this daily.
- Avoid using harsh soaps and scrubbing your vulva vigorously. If you must use a mild baby soap and rinse generously, otherwise a soft cloth and water will do.
If you have a past history of breast or uterine cancer, avoid estrogen. You may benefit from a natural progesterone cream, 1/4 teaspoon applied into the vagina 3 times a week and applied to the skin daily.
Sex is an important part of your life. Regular intercourse will make you healthier, happier and you will live longer. Don’t give up on it. Many post-menopausal women enjoy active and pleasurable sex with their partners. With care and perseverance, your sex life may be better now than it ever was.
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Thanks for the info. Its more than I have gotten from 3 doctors. After being on prempro for 5 years, 5 months ago, I went to the lowest dose. I have had nothing but problems for the last 2 months. Frequent urination, with neg. urine test for uti. I have been using progest for 3 weeks, I wasnt aware that I could use that on the vulva area. It is very irritated and burns when I urinate. Thanks again.
Hi Christy. Thanks for taking the time to leave a comment. Sorry for taking so long to reply. I`m so thrilled that I`ve been able to help. Take care and thanks again.
I do not like to take any prescription medication but I was so distressed post-menopause that I decided to try vagifem tabs. The loss of estrogen and the uncomfortable symptoms made me feel less than human!
The vagifem tabs worked and you don’t have to use them every day.
A vitamin E supplement every day has brought further improvement.
thank you for the info.I just started using vitamin e capules.burns a little.Im also on bioidenical estridiol cream,this burns more, but is helping with atrophy and moisture.I have also been using extra virgin coconut oil, this helps alot! been using this for a week now.Im hoping it wont cause a bactreial infection, because it really soothes my dry irritation.
My husband doesn’t care if I hurt or bleed or have any problems in fact the discomfort turns him on more. He also hates lubricants and I can attest that they give less friction and he takes even longer causing even more pain. I am 50 on birth control and my doctor wont give me estrogen cream as I am on the pill and don’t need. I am now getting cracked nipples and all of my skin tears, cut and bruises all of the time
My comment is for Teresa – why on earth would you even think of having sex with a man who ‘doesn’t care if I hurt or bleed or have any problems in fact the discomfort turns him on more’?
Any man who gets turned on by his partner’s pain or bleeding is a sadist, IMO, and should be avoided like the plague. Sex is supposed to be pleasurable for both parties, not something that women endure while their husbands enjoy themselves. It’s one thing having sex and feeling a bit of discomfort due to age or whatever, it’s something else to have a husband who doesn’t care or – even worse – enjoys causing his wife pain.
For goodness sake, tell him you’ll have sex when you find a way to do so without pain or bleeding AND only if you feel like it. If he’s not happy, then tell him to take a hike. You only get one life and you don’t need to spend it pandering to the wishes of an insensitive oaf. (I wish I had your husband here with me for half an hour – not for sex, you understand, but for a few plain home truths.)
I use Super Critical Omega 7. It supports the mucous membrane of the vaginal. It really lubricates the vaginal walls. I take 2 to 3 softgels daily. I space them out 1 in the morning, 1 in the afternoon and one in the evening. I also take fish oil and ultimate Flora Vaginal Support, it supports vaginal and urinary health.
I recently have had major issues, hot flashes, night sweats, memory loss and others but I wasn’t aware of the vaginal issue. I’ve been to my doctor 2 times to be tested for infection, but it came back negative. I haven’t had intercourse in almost 2 weeks and one minute I’m fine and the next minute I’ll experience a pain, vaginally, that last for some time. It seems to get better when I drink a lot of water. What can I do to make this stop? It is really related to menopause?
I am currently in chemo for breast cancer.stage 1.lymph nodes clear.but 100% positive for Hertu..which basically means I caught it very very early (self examine ladies!!!) but it was a very aggressive estrogen based cancer..the chemo is forcing me through a rapid menopause..and while I was prepared for the nausea and discomfort of the drugs..no one told me about the symptoms of menopause I would feel at the same time..sex..with a man who adores me..has become very painful..now I learn that the dryness and bruising is very normal as my estrogen/ovaries are being nuked!! So! I cannot take estrogen creams..have been told NO antioxidant supplements as the chemo process uses the oxident process to kill the cancer cells..so my question is..sorry for the ignorance..is E not a viable solution for me..i need something to help build back moisture so I di not bruise so readily.my advice from what this journey has taught me…check your Tatas monthly!!! Please!! And Therese GET OUT! Of that relationship. I was in an emotionally abusive relationship for 25!!! Years thinking it was the best I could do!! There is life after you leave..the first step is the hardest..but love yourself enough to go. I am sure that marriage created my cancer!!