Vaginal Atrophy

Posted by daisysocal @daisysocal, Sep 27, 2022

Seems like vaginal atrophy is a taboo topic, yet so many women are suffering with this. I had breast cancer and was on anastrozole for 7 years. I’m not sure if my Intercourse pain is due to lack of estrogen from the estrogen blocker or from menopause or both. I have opened up about this with female acquaintances and have found there are so many women who suffer from this. It’s a subject so difficult to discuss with your husband, partner, doctors, etc. Many women have told me estrogen creams don’t work, Mona Lisa type treatments don’t help, and our sex lives are non-existent. I was a very sexual woman, wife, enjoyed sex so much. I am very active, attractive and fit at 60 years old. But quite honestly I feel almost worthless when it comes to being intimate. It’s really sad and I wish I could have normal sex again without feeling like I’m being stabbed by a knife, hiding my face crying, and swollen. In fact, I stopped having sex altogether about 2 years ago. It just really stinks.

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@cashemire

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??

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A friend of mine got a set of dilators- you start with the smallest, and slowly work your way up to largest (or however large you want/ need it!). Her new partner is rather large, and between that and her vagina shrinking, penetration was painful. Good news: it worked really well. They aren't that expensive and do work.
Personally: I felt like my vagina was a tad snug after having no sex for 2 years. I decided to try a couple of different vibrators to get myself back into the hang of things, and the kind that also serves as a dildo was initially a bit big to get inside of my vagina. Using some good lube was quite helpful, and not trying to go to fast... Highly recommend it as a more fun way perhaps to loosen up your vagina. 🙂
Lastly: I highly recommend - now that I am having sex again- using lubricants. We have found that nothing is better than the silicone lubes, as they last. Water based dries out in minutes! I did research on the ones Mayo carries, and the Sliquid brand is definitely one of the very best out there! They even have "cubes" with an assortment to try. They have many options, both water and silicone based, organic or not, "tingly" or not.... You may have to try and see what works, but it makes a big difference! Good luck to all...

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@marjou

@daisysocal 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.

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@daisysocal An update to this topic. Have visited a female Ob/Gyn about this uncomfortableness of this and has prescribed a very small amount of estrogen which has made it much more comfortable.

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I see a uro-gynecologist and she sent me for pelvic floor PT. I had to get serious about this, meaning keep up with doing it at home. If I do the pelvic floor exercises with the dialator every other day and use estrogen cream, my symptoms are much better.

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@kell4042

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.

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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.

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@siosal

Can u name the pharmacy that u use?

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I use the medicine shoppe

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Reply to all (I hope, ha ha) as of August 19th. I haven't been able to get back to the Viveve due to a new complication - I have been diagnosed with Sjogren's Syndrome and have been fighting my way through this one. Now I have the added problem of dryness from this auto immune disorder where my immune system is killing off all my moisture. My Rheumatologist says the Viveve won't help (?) but he's also a male and about 35 years old....so..... I continue with Replens and Estrogen weekly but the new meds for the auto immune have caused 2 yeast infections this month and I have diarrhea, chills and fatigue of an unknown cause. I'm actually sicker once I got my diagnosis than when I started (sigh). I can feel what little moisture that is left in my body leaving me daily....so I need to get the auto immune under control and then I can get back to my vagina. Hang in there ladies and I'll keep you posted on anything new I learn or do. Hugs.

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@naturegirl5

@daisysocal 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.

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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

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@kell4042

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.

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Your condition can be surgically corrected (I have a similar condition, with about 4 to 5 cm depth left). There is a surgery called PPT ( peritoneal pull through), with which they use part of the peritoneum to extend the vagina.
The surgery requires a few days stay in the hospital, but when it is healed out, your vagina should functions similar to before.
I think if you are sexually active, and still young enough, it is a surgery one should consider.
I am relatively old, an I am not interested in men anyway. That is the reason why I don't have this surgery done.

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@jessy0628

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

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My gynecologist recommended using hyaluronic based moisturizers. I had been buying generic ones at CVS, but she recommended using Revaree by Bonafide instead. It's more expensive but I'm switching over as it has better ingredients (no surprise).

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@naturegirl5

@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!).

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After deciding not to use estrogen cream and being in pain from splits in the labia, I went to a GYN that recommended organic coconut oil applied externally only. I have used that for years now and no longer have discomfort. At all. However, I have not had sexual intercourse for many years so I can’t speak to that. I am 76. I had a vaginal hysterectomy at 42 and never could have intercourse again due to the pain. No doctors had an answer for me at the time so I gave up. The last doctor shrugged and said, “use it or lose it.” Ugh.

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