Vaginal atrophy and painful intercourse: What helps?

Greetings everyone.
I've been reading all the postings and thank you all for discussing this very difficult, sensitive topic. I had an early menopause at 43 and have been on estradiol vaginal cream ever since but I still had painful intercourse from time to time. I experimented with moisturizer/lubricants (because my doctors were useless) and started applying Vitamin E before intercourse. Then when I felt that was no longer enough, I started using Vitamin E suppositories before intercourse, which helped. Last fall I noticed increased pain and observed a crack/fissure in the perineum which healed but have had recurring fissures in between labia occurring after intercourse and sometimes for no reason at all. My female GYN (my age) recommended Hyalo-Gyn, which I tried but burned terribly. I called the company and got my money back. They said they were using a different preservative. My GYN has nothing else to say. I'm so disappointed, I thought she would have more/better recommendations.
Last night I tried my first application of VMagic - an all-natural vulvar balm. The good news is, it didn't burn and seems to have already helped alleviate the chronic, daily unrelenting itching I experience. I also ordered and am going to add Meno Moist suppositories, another all-natural product to see if I can stop estradiol cream completely since I don't think it's working and I think it's time to stop with the hormones already.
I'll post again when I know more about how this regimen is working.

I plan on trying the Viveve procedure in the near future and will report back to everyone. I am 65 and have severe vaginal dryness and atrophy. In my case it has caused a prolapse of my bladder into the vaginal canal which causes other issues. The Viveve procedure may help that. It is considered 'cosmetic' by insurance but I plan on fighting with them and Medicare to see how far I can get with that (it is expensive, $2,500) and works differently for every woman. For some, a year....some five years, some one treatment and done. I figure that with all the creams and a possible pessary in my future, the investment may be a good one. Also, if it gives me relief after all these years....it will be worth it for any length of time. Something to consider perhaps. It's still on the 'newer' side and there is a little controversy about it but it seems very safe. Different than Mona Lisa it uses both hot and cool to make the procedure more comfortable during and following. (and I will close with this, and I don't want to offend anyone but....there sure seems to be a lot of support for men's sexual health but women, well, we're still in the dark ages with the medical community, sigh). Hugs to all.

I don't understand what is cosmetic about women's sexual health. This has been a 20-year+ struggle for me and my GYN never even asks how I'm feeling down there. I selected my Medicare advantage plan solely on the cost of estradiol cream. Under some plans the Rx was so expensive! and I think it is another example of the "pink tax". I strongly agree with your last comment, which is why I was so hurt when my GYN shrugged her shoulders and had nothing more to offer that going back to Vitamin E.
Good luck with your Vivive treatment. I sincerely hope you get some relief from your problems.

You are speaking my language. I have tissue health issues post early menopause from total hysterectomy. I too am 43 yrs young. I've gotten to point where I can no longer even manage intercoarse for very same problems plus vaginisum (pelvic floor muscle tension/spasms. Possible bladder drop, causing complete inability to even penetrate period. I've struggled since 2018 when I had hysterectomy through vaginal. Following this. Also, I'd love to share what I'm doing for help and what I experience w extremely painful intercourse, vulva tears, burn, etc

I too have found estradiol cream to be very expensive. I only use 3 drugs (I consider myself lucky in that department) but the ones I use are expensive. My new Urogyno suggested a compounding pharmacy for my prescription now, which cuts the estradiol cream cost in half! Maybe try that? (One of my other drugs are Restassis eye drops.....I picked my prescription plan to cover those because not all plans do..... and they were $300 per month! With a Single Care coupon I'm getting them for $30). It is a 'pink tax'.......less care, research and hiked prices taking advantage of women, probably because so much has traditionally been managed by men, sigh. No offense to men in general.......just the way the system was built. We just need to raise the questions over and over in hopes of getting things to improve. Hugs.

@cindylb

I get my estradiol from a compounding pharmacy and have it mailed to me. Cost is $60 for about 6 month supply..used twice a week.

FL Mary

That's excellent. Thank you for sharing.

I'd love to hear how you are coping/treating your symptoms. I'm still testing the meno moist and v magic, both available on iherb. I think the v magic is helping the constant itching, now its only occasional. But still tearing with intercourse. Same place. I think I'm going to try to find a different specialist. Don't know who, but my gyn is useless. I wonder if there is some kind of PT to do.

So what I've learned is that tissue health degrades with menopause, however vaginisum required pelvic floor therapy for muscle tension and muscle spasms. My understanding is while muscles are tense, there is lack of blood flow to the tissue in and around the vulva area so that tissue is constricted and can't plump up. I invested in a book on vaginisum and a pelvic floor wand, specific for trigger pain through massage of the muscles in pelvic floor to teach them to respond differently to penetration and allow more blood flow to tissue, plumping it up. And I use a numbing agent right at opening. All takes about 3 months to get those results. Make sure when you take breathes, slow tummy inflating inhales, supposed to help lengthen the cavity as well.

Can u name the pharmacy that u use?