Vaginal Atrophy

@bp50 I used the estradiol cream for several years and it worked well for me. Unfortunately, as my doctor says, "estradiol is off the table" because I was diagnosed with endometrial cancer in 2019 and have to be careful about what I use. I did not have the dead vaginal cells sloughing off as you describe when I was prescribed estradiol vaginal cream. I was having pain during intercourse so that is what started the discussion on how to manage the vaginal changes.

Does estradiol work for you?

It seems to if I stick to every three days. But it seems to be a fragile improvement. I divorced about 6 years before this became a “fix it” state. So I didn’t have the sexual impact several describe here. I needed to control the yuk and sour smell. But there’s no fixing it. Miss a scheduled day or two and the foul discharge is right back. I just thought perhaps Someone else had a new approach.

I also had to stop using estradiol when I got ER+ breast cancer. My doctor recommended using a cream with hyaluronic acid when the moisturizers and lubricants were not helpful.
When I started Tamoxifen I got a surprise. Hormone therapies can reduce estrogen so low that makes vaginal atrophy worse. But for me, 18 years postmenopausal, Tamoxifen is acting as an agonist in body parts other than my breasts. That means it promotes an estrogenic like response - so my vaginal atrophy is gone. It’s a little unnerving and it makes me worry - but evidently it is an expected response for someone like me who had really low estrogen levels before starting hormone therapy.
It also makes me wonder if the estradiol that I was using on a regular basis prior to BC diagnosis really was part of the reason the cancer started growing when it did.

One thing I wanted to mention, since we’re on this topic 🙂
Warning, warning, graphic topic following!!
Would it make any sense that part of the problem with vaginal atrophy and sex is that the clitoris goes limp? Do you also have that problem? That the clitoris won’t/can’t get aroused? It’s not just that the vaginal skin is thin and dry.
Would increasing the blood flow to the clitoris make a difference? For men, if they have sexual dysfunction, they are more likely to get a little blue pill that is a type of vasodilator and allows more blood flow to the penis. Increasing testosterone alone does not fix the problem.
So we’re looking at female issues and only thinking that estrogen is the answer? (Besides just masking the problem with lubricants). Low estrogen is definitely driving the loss of skin quality and moisture. But maybe a little extra blood flow to the area would not only improve the skin but also help the clitoris to stiffen and become aroused. If they can manufacture a little blue pill for men, maybe they should look into creating the same function for women.
I know there is supposed to be a female viagra but “both available drugs boost the activity of chemical messengers in your brain, called neurotransmitters, that are key to helping you feel aroused.” (Cleveland Clinic)
But vaginal atrophy is not a problem that can be solved in my head. I’d like to see them really find a solution to boosting blood flow to the clitoris. Maybe that along with moisturizers, hyaluronic acid, and lubricants will bring sex back again.

Keep searching girl. I am old and divorced so my priority isn’t my sex life, but I surely recall when it would have been 🙂

I t seems that with or without a sex life, we still need to address the vaginal dryness problem.
I had pelvic floor PT which taught me a lot. After struggling with it at home and finding it to be tedious and another chore that i had to manage, I got a vibrator and just masturbated.
The increase in blood flow is therapeutic- or so I hope.
And, I use estrogen cream.

This thread is very interesting. I read the entire thing as I started using Estradiol twice a week a few months ago, I didn’t think I needed it, because I had not noticed any vaginal dryness or irritation. I hadn’t had a yeast infection nor UTI in years! But, I requested it from my primary after watching several you tube videos with women Urologists! I was blown away by what these dictors said. Basically, they said bladder problems in post menopausal women is a huge issue due to vaginal atrophy/loss of estrogen. They promote local estrogen in almost all cases and even say they can’t imagine any cases where it’s not advisable. I’ll have to find the link, if it’s allowed. Anyway, I don’t know if that is true. But, it got my butt in gear to address it before I encountered problems, like my mom who has huge incontinence and irritation issues.

I saw the difference pretty fast. It’s like the old me is back! I am so glad I found it and ticked off no doctor ever suggested it to me! Why? I now feel very sexy and feel aroused a lot of the time.

I also got my dilator kit on my own, I actually already had a vibrator the size of the next to largest size dilator and so I went straight to the largest the second day and maintain with that one. I prefer the hard surface type as they are easier to clean and smoother on the skin. Personal preference I guess.

My last intimate relationship was a few years ago and I want to fix that soon. That’s a major goal for me and I want to be ready. Any tips? I’ve checked it out myself and have practiced self care all of my life, when not with a partner, so I’ve had almost daily orgasms for years. Even since menopause. I’m still apprehensive. I’ve considered seeing a PT person for pelvic floor evaluation. I’ve gotten annual pelvic exams and PAP tests, but I don’t think they check on what I need checked. Lol Has anyone gone in specifically for that reason? I just want to make sure I’m ready. Is the dilator a good indication of accommodation?

After my lady parts began prolapsing I was desperate for help. When my gynecologist told me some women have vaginal prolapse they actually have a bulge hanging down, much like a man’s scrotum. I was not interested in a surgery ‘which may help’ I was desperate to find an answer. A close friend had mentioned she was going to ‘pelvic floor training’. I called her right away for more details. I asked my primary care physician to write an order for pelvic floor training. I was taught exercises to rebuild those muscles. The therapist told me our vaginas are ‘like a woven basket that holds things in place’. I am very pleased with the results. I will gladly continue the exercises. Occasionally, If I’m totally worn out, I’ll skip a day.

Did you see a physical therapist for the training? I’m not sure if I need the therapy, but would like an evaluation. Maybe, I’ll try the intercourse to see how it goes.

So glad you had good results with that therapy! My mom has had 2 surgeries for prolapse years ago. I have done kegel exercises before. I became concerned that I might be hypotonic, since I’m such an anxious person and discontinued them. Perhaps, I’ll resume them.

@celia16 I'd like to validate every thing you are doing to maintain function. Like you, I used estradiol twice a week and I will tell you it really helped. Several years after I began using estradiol I learned from a nurse educator at the Minnesota Mayo Menopause and Women's Sexual Health Clinic that it wasn't necessary to plunge all the cream all the way up the vagina. That's messy and not needed. Instead, I applied a smaller amount the opening and about the lower 1/3 of the vagina and that worked very well. I also saw a pelvic floor physical therapist and followed up with the exercises at home. This also helped as I incorporated those exercises into my yoga practice.

Unfortunately I can no longer use estradiol because I had endometrial cancer 4 years ago. I was advised by my doctors not to use it anymore. I now use HyaloGyn which is an over the counter vaginal lubricant. It can only be purchased through the website. It works but not nearly as well as the estradiol.

Hyalo Gyn

-- https://hyalogyn.com/

I've used a vaginal dilator as I had vaginal brachytherapy for the endometrial cancer. The dilator worked very well however that type of radiation therapy shortens the vagina and there is scar tissue at the site of brachytherapy so sexual intercourse is painful for me. That's a huge disappointment however there are many other ways to be together and have orgasms. So that's what we do. I should add that we always use a lubricant and there are many over the counter choices for that.

I was told by the nurse educator I saw at Mayo Clinic that vaginal health is important whether or not you are sexually active. Since we, as women, will. have pelvic exams for a variety of reasons over the years these measures will make us more comfortable and provide a good "view" for the medical provider.

I appreciate that very informative post! And that link. I’ll check it out. So glad you are doing so well with the alternate cream. I am so glad you mentioned the proper application method. It makes sense.

I look forward to trying out these ideas. I’m apprehensive, but know it will be worth it. I’ve bought some lubricant, but it’s water based and I’ve since read here that it dries too fast and silicone is better…..but, I can try both.