Vaginal atrophy and painful intercourse: What helps?

If you have not seen a specialist, I suggest you talk to someone about options. Mayo Rochester has a Menopause and Women's Sexual Health Clinic. I have not been seen at clinic, but did see a provider in Rochester Mayo Gyn section who had excellent suggestion. Check if a local clinic provides specialist in Women Health.

I am 67, with history of breast cancer. I had a total hysterotomy in my 40s due to endometriosis, so been post-menopausal for long time. My primary provider mentioned Vaginal Atrophy in a clinical note but never said anything to me. I decided to follow up with a gyn appointment, and discovered I had lichen sclerosis that primary missed.

Because of history of ER+ breast cancer, any estrogen cream was not recommended for me.

This is Mayo Q&A on subject:
https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/vaginal-dryness/faq-20115086
It is funny that there are so many commercial about male sexual problems, but never anything about women sexual problems.

Do not give up.

Laurie

I have used an estrogen cream for years when my female nurse practitioner in an oby/gyn practice recommended it and for me, it works. There are lubricants that you can use prior to intercourse. I agree, even my best friends don’t want to talk about anything “intimate”. I think it’s this generation …friends are mostly in the 70s and early 80s. A fellow I was dating years ago talked about it with me and we did use a lubricant on occasion. We used to joke about it …where there is a will there is a way. Not all partners are as enlightened sad to say….affects both men and women of my generation.

FL Mary aka Hurricane Mary at this point…just north a bit of the major impact but tonight will be the worst.

I have struggled with the very same problem for at least 8 years. It's been so awful and at first I got nowhere. I talked with my gynecologist and my primary care doctor during that time and received very unsatisfactory answers. I felt like no one took me seriously. Finally, I was prescribed Estrace vaginal cream that I used and it did help although I still experienced some pain with intercourse on occasion. My partner and I were already using a lubricant during sex before I started having the problems.

I learned about the Mayo Clinic Women's Menopause Clinic from my nurse practitioner at Mayo Clinic. I have been seen at that clinic and it's been so very helpful. I feel like someone finally gets what I've been going through. I've seen a psychologist who specializes in sex therapy, education nurses who explain different types of vaginal moisturizers and lubricants and a nurse practitioner who did a complete exam with me holding a mirror so I could see what she saw as she educated me.

If there is a clinic like this near you I highly recommend it. Because I had endometrial cancer I can no longer use the estrogen cream (applied topically only to the lower 1/3 of the vagina by the way - instructions I got from Mayo Clinic that were different from what is on the package). I now use non-estrogen vaginal moisturizers a few times a week that work for me. And here is one other tip. My partner uses Ohnuts (I bought as a gift for us) which reduce the depth of penetration. We have both needed to change our expectations about sex . It's been more difficult for me than for him because like you I loved what my body did in the past and just let it do that. I can't do that anymore.
https://ohnut.co/
I hope this helps. It is a constant struggle to find out what will work for you but I think it's possible.

Bravo for bringing this topic up for discussion. I’m 67 yrs and think like you do but am single. The discomfort is awful and have addressed with my ob/gyn but no viable options. My belief is that this has not been addressed by medical community especially those who of certain age and those who estrogen is not an option due to family history of breast cancer.

@marjou I agree with you that vaginal atrophy is not addressed in the medical community. I was told in radiation oncology to use a vaginal moisturizer because of the radiation therapy. I also use a dilator a minimum of twice a week as this keeps the tissue healthier because the radiation therapy both scars and shrinks tissue. The main reason for doing this in oncology is to make sure the vagina can be easily viewed during exams. There are apparently women who do not do this after gynecological radiation therapy and then tissue at the top 1/3 of the vagina becomes constricted.

With all that said the nurse practitioner in the Menopause and Women's Sexual Health Clinic at Mayo told me that all women, sexually active or not, should use vaginal moisturizers to prevent vaginal atrophy. This allows the woman to feel more comfortable because sometimes vaginal atrophy can cause pain and discomfort. She compared it to moisturizer any part of your body. She asked me if I apply moisturizer to my face? I answered, yes (of course I do). So now I moisturize inside and out.

Do you think you might like to try this @marjou? If yes, I can post some links to products that were recommended to me and tell more about what I like to use (This post is already too long!).

Hi, I am new to this group and will be finishing chemo soon and will be having radiology in about a month. I also saw a note in my files that I had vaginal atrophy. but no one talked to me about it and I have been too sick from the chemo side effects to research. @Helen, can I ask you to share the products you mentioned in you post? Thank you so much,
Sue

@fight777. Hi Sue, Here are the products I've learned about. I'll write my little review with them too.

-Hyalo Gyn (only available online from the company). This comes in suppositories or cream. It contains Hyaluronic Acid which is highly recommended by my radiation oncologist. I use it in suppository form as it's less messy and less to go into the landfill. I have a standing order that is shipped so I can get a discount. I use it with a little of Good Clean Love Bio-nourish (available from Target but also from Amazon which also has hyaluronic acid. I put the Good Clean Love product on the suppository and on the entrance to my vagina and then it's easier and more comfortable to insert. I do this 2-3 times a week.

--https://hyalogyn.com/

Bio Nourish (a little goes a long way).
https://goodcleanlove.com/collections/vaginal-care/products/bionourish-moisturizing-vaginal-gel-with-hyaluronic-acid
Satin by Sliquid. Mayo clinic recommends applying a little every night to the entrance of the vagina. I'm not doing this now as I've been using Hyalo-Gyn as I described because of radiation therapy.

--https://www.amazon.com/Sliquid-Organics-Natural-Satin-Lubricant/dp/B00763K1IU

Mayo Clinic sells all of these products in their physical and online store except for Hyalo-Gyn.

You can see I've done a lot of trials and figured what works for me. I know you will do the same.

You wrote that you are finishing chemo and will start radiation How are you feeling?

You started a topic that many of us have been dealing with. Thank you for doing that. What do you think of the responses? How are you doing today?

Im 57 and was suffering from pain and discomfort.
My doctor recommended repa gyn and it has helped tremendously! Easy and safe too.
Good luck.

My vagina health deteriorated rather dramatically after my doctors would no longer prescribe estrogen based on my age. I can't toleralte any of the vaginal creams, they cause burning and itching. I have severe Allergic Contact Dermatitis, a form of eczema resulting from contact with many everyday contacts most don't react to. I have learned it's not the estrogen itself, it is the inactive ingredients used in the inserted creams.
Surprisingly I do tolerate Estring, which is a silicone ring infused with time released estrogen, you personally insert this into your vagina, it stays in for 3 months, yet once a week or so you must insert a finger to make sure it has not drifted toward the opening. Ocassionaly, after a bowel movenment in which your bore down, you will feel pressure toward the vaginal opening and that means it is too low, when inserted properly you feel nothing. I have used this for over a year, it has never fallen out. It is not noticeable when having intercourse. It has restored my vaginal health and I no longer have to deal with vaginal pain during intercourse and a benefit also is that I no longer have any odor from the vagina because by restoring normal secretions the vagina washes itself.

Yet, I do believe that although this time released estrogen is localized in the vagina, there is a possiblity some could migrate into your blood and to other parts of the body, so do ask your doctor about this expensive prescription. My medicare pharmacy supplement helps, but it still costs about $300 for a 3 month ring, however the benefit to my marriage and my own pleasure is worth the expense. To save money I have tried making it last past the 3 month window and to my surprise, within a few days before the end of the 3 month window slight burning and a beginning odor reoccur.