Vaginal atrophy and painful intercourse: What helps?

@ladonnaa

Re my provider suggestion I meant an OBY/GYN in my previous post.

FL Mary

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??

@cashemire I had external pelvic radiation therapy and two sessions of vaginal brachytherapy for endometrial cancer. I was advised to use a vaginal moisturizer to encourage healing and reduce scar formation. I was also advised to use a dilator because scar tissue from brachytherapy can occlude the vagina. This is a problem whether a person has a sexual partner or not. The reason is that with periodic pelvic follow-up appointments (I just had one this morning) the medical provider needs to be able to look in the vagina with a speculum. Since I've been using a dilator for over a year I learned that the moisturizer and the dilator both helped to expand tissue.

I found it difficult to get up-to-date medical care in my community for vaginal atrophy when I first became post-menopausal. What I have learned came from radiation oncology, and in-person appointments with the Women's Menopause and Sexual Health Clinic at Mayo Clinic in Rochester, MN.

Do you feel comfortable talking with your primary care provider or your gynecologist about this?

@naturegirl5 Many thanks for your feedback! Actually, I brought up the subject of dilators when I recently had to undergo the attempt to get a uterine biopsy, asking one of the gynecologists attending the procedure (they did not get a sample so I have to undergo a hysteroscopy soon). She didn't sound too hopeful about dilators saying something to the effect that since they are rigid it could cause things to tear. But it sounds like you had some success so that is hopeful.

@cashemire Hmmm. That's unfortunate that the gynecologist did not think a dilator would be of use. I'm going from my experience. I do have a partner so I had been sexually active however the Mayo Menopause and Sexual Health Clinic providers told me that it's always good to keep your vagina "healthy". This makes it easier and less painful for you when you have internal pelvic exams. I had never thought about it in that way.

This is something you could get another opinion on from another gynecologist or from your family doctor. If you do get a recommendation for moisturizers and a dilator I can recommend that you find a soft dilator. I find it more comfortable to use. Mayo Clinic sells vaginal moisturizers and dilators at their Mayo Clinic Store which you can access online.

Mayo Clinic Online Store

-- https://store.mayoclinic.com/health/women-s.html

I use a vaginal suppository called Hyalo-Gyn that can only be ordered online and you don't need a prescription.

Hyalo-Gyn

--
https://hyalogyn.com/
I also use a moisturizer from Good Clean Love in a tube to help insert the suppository and nightly in the vulva and lower vagina. Target carries the Good Clean Love brand or you can order online from Mayo Clinic. I use the Good Clean moisturizer with hyaluronic acid as that was recommended by my radiation oncologist.

-- https://goodcleanlove.com/

@naturegirl5 Many thanks for these ideas...I will try to see if Mayo clinic will ship to Canada!

These things have helped me:
HyaloGyn gel
Monistat Chafing relief Comfort Gel
(both used externally on vulva to add mousture and reduce friction)
K-Y liquibeads once a week
Estring
Estrace cream just at the vaginal opening, once a week.

I'm allergic to a lot of inactive ingredients in creams and lotions too. Anything botannical, fragrance, and a preservative called phenoxyethanol all cause irritation. I look for products with the fewest ingredients. The Estring is great because it's just estrogen in silicone, which feels like plastic but is actually an inert mineral. I like Monistat Chafing Relief Comfort Gel and KY Liquibeads for the same reasons. And so far HyaloGyn moisture gel works for me. It burns at first, then ferls good after a few minutes. I think the burn is because it's acidic and my vulvular skin was dry and irritated. It seems like it burns less after 2 weeks of use, and my skin feels healthier.

Have you got your testosterone tested?

Phenoxyethanol has replaced many preservatives which were proven to cause allergic reactions like methylisothiazole, MI, in many topicals. I am also allergic MI and to phenoxyethanol. As you these chemicals are in many topicals to extend shelf life. I've never gotten any feedback from anyone who also uses the Estring and you mentioned you still have some vaginal discomfort.
I can't remember if I previously mentioned in this discussion that restoring my vaginal help was two fold, not only the Estring which restored my vaginal moisture but months earlier I read The Yeast Connection Handbook, by William Crooke, Md. His simple short book is written for the layperson, contains hand drawn diagrams showing the relationship between the yeast residing in all our intestines and how their hunger for sugar controls our brains, causing us cravings, and how in turn feeding yeast this sugar increases the colony size which in turn increases the craving more. If you give up procedess sugar you will acutally go through detox. I gave up alcohol several years earlier and I only craved it for 3 weeks. Now years later I have no interest at all in alcohol. Giving up sugar is much harder. The waste from yeast transfers though our intestinal linings (more as our linings thin with age). This waste then enters our blood stream which in turn raises up our histamine armies which battle this waste trying to protect us and raise our inflamation which can affect various parts of our bodies and cause multiple diseases. Keep in mind I didn't test positive for yeast or have the classic yeast vaginal discharge. I followed Crook's detox diet for 3 months rather than the 2 it asked for and now several years later no longer follow the maintanence diet, other than I am off processed sugar for life. I eat multiple servings of fruit and the all non sugary carbs and gluten I want. My vagina is healed again. It took at least 2 years for my mouth not to water just thinking or viewing or smelling foods with processed sugar. Now 3 years later I have little interest and only one serving of dessert about 3 times a year on holidays. It's a slow and challenging process, but to be free of the burning and pain gave me motivation.
It's hard going through this detox not knowing if it will help. The yeast doesn't want to die of starvation. You won't because you are still eating meat, poultry, fish and non starchy veggies. Basically a Keto type diet for several months. You will loose weight, but will gain back some once you go back on non sugary carbs and fruit.