Vaginal atrophy and painful intercourse: What helps?

I would like to know whether anyone has used dilators with success over time and how long to get there? Many yrs as a single without partner and being long postmenopausal no doubt are main factors. Do they really work to expand shrunken tissue??

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.

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?

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.

So turns out all the above is true but in addition, when I had hysterectomy vaginally, they cut out too much of vaginal canal, from entrance to internal end, mine only measures 7 cm. And there is no way to fix, stretch or lengthen. Told nothing can be done, it's always going to be too short for intercourse, will always be painful and sexual intercourse for me, basically over.

Would you mind mentioning the vaginal moisturizers you are using as i am not into estrogen creams as well. Had my total hystrectomy 3mos ago with stage1a grade1 path report. Thank you

@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!).