Vaginal atrophy and painful intercourse: What helps?

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.

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?

@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.

@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!).

I would love those links!

@celia16 I like silicone too but it's messier. There are some products that are hybrid water-based and silicone-based. You can find Sliquid on their website and I believe it's also sold through Amazon. I first purchased this product at the Mayo store as it was recommended by the nurse educator. It's a trial and error as you'll want to find what works best for you. On the advice of my radiation oncologist nurse I use KY Jelly as a lubricant with my dilator. Silicone-based products are not recommended and the other water-based products dry out too quickly.

Sliquid

--- https://sliquid.com/shop/sliquid-naturals/silk-sliquid-naturals/

Any other advice you'd like to share will be so appreciated here. I'm so glad you are doing well with the methods that you have chosen.

Do you how Replense moisturizer compares to those above?

May I ask a likely elementary question? I had a hysterectomy at 38 and was not offered any HRT of any kind. At age 64, I developed a sticky, sour smelling discharge and learned it was vaginal atrophy sloughing off dead cells. The GYN prescribed a 10mg estradiol suppositoryi insert twice a week. And after quite a while that seemed to resolve it. After a few years I stopped the HRT. but recently I had to resume. So apparently the condition doesn’t get fixed… just managed.

So here’s my stupid question- would moisturizer do just as well? I’m reading about many of you using non hormonal moisturizer and am wondering if that’s an option for me. I am somewhat worried about HRT forever.