I have an embarrassing problem. I am 52 and have been happily married for 18 years. Lately my vagina seems dry and tender. And after sex my vagina burns and feels sore. Is there something wrong with me, and what can I do about this?
Parched in the Privates
Welcome to the second act of the Wonderful World of Womanhood.
In Act One we were treated to scenes of bleeding, cramps, and childbirth. Just when we’d gotten a handle on all of that Act Two comes along bringing with it vaginal dryness, night sweats, and chin hairs. Lucky us.
Vaginal dryness is just one of the symptoms of something called vaginal atrophy (Aack!). Other symptoms of vaginal atrophy are burning, soreness, painful intercourse, and frequent UTIs.2
What the F&*K is Happening to Me??
What is happening is that our plump and pretty little ovaries—which are where estrogen is produced–are shriveling up and wasting away. Check out this super-scientific illustration that will help you visualize what’s going on:
Because of this, your vagina, once a verdant garden of pleasure,
can become a dried-up wasteland.
What is a girl to do?
See Your Doctor
The first step is telling your healthcare provider what is going on. Most likely you are going to have to be the one to bring it up.
Because most of us don’t get sexually stimulated during a vaginal exam, your doctor can’t tell how well you’re lubricating during sex. And because doctors are people too, and people have manners, they most likely aren’t going to point out that your vagina looks like the Sahara if you don’t complain.
They are depending on you to tell them if you have a problem!
After a thorough internal exam and a health history, your doctor will likely recommend one or more of the following treatments:
Sexual lubricants are often enough for treating mild vaginal dryness. You are probably familiar with the water-based lubricants like KY and Astroglide, but I really like a silicone-based product you can get through Amazon called Wet Platinum. Just remember that you can’t use silicon-based lubricants with silicone sex toys!
Avoid the ones with irritating chemicals that promise to give you a “new sensation” because that new sensation might be the feeling like your vagina is on fire (Read this post if you want to read about my own experience.)
Vaginal moisturizers are not the same as sexual lubricants. These products are long-acting, non-hormonal gels that you insert with an applicator during non-sexy time every 3-5 days to keep your lady parts supple and moist and ready for action. These products work by coating dry, compacted cells and protecting them while your body naturally regenerates some new juicy cells.
Clinical trials show that vaginal moisturizers are just as effective as vaginal estrogen in treating vaginal dryness, making this a good choice if hormone replacement therapy is not an option for you due to concerns about cancer.3
Two products on the market are Replens® and one I reviewed called Hyalo GYN®. Replens is available everywhere, but it gave me a weird discharge that was unacceptable. Hyalo GYN didn’t cause the discharge, but it isn’t easy to find in stores and you have to use these products regularly to get the beneficial effects.
Vaginal Estrogen Therapy
Estrogen therapy became very controversial after a large longitudinal study called the Women’s Health Initiative found that “synthetic progesterone, when used with synthetic estrogen, increases the risk for breast cancer in some women.” This finding has been repeatedly reported in the media and now many women and their doctors are afraid of estrogen for fear of breast cancer.4
This isn’t the time nor the place to explore this complicated issue, but if you are interested in doing research for yourself here’s a couple of links to start.
- Dr. Joseph Mazzei over on The Perimenopause Blog gives an interview on the safety of estrogen.
- Dr. Oz’s expert gynecologist, Dr. Streicher, writes specifically about the safety of vaginal estrogen.
One thing you need to know is that vaginal estrogen is considered more effective in treating vaginal atrophy than oral estrogen. And since vaginal estrogen enters the blood stream in very minuscule quantities they are safer than oral estrogen for women with cancer or blood clot concerns.
Studies show that bioidentical vaginal hormone replacement therapy is just as effective as synthetic hormone replacement.5
Vaginal estrogen therapy comes in creams, rings, and suppositories. Oh my.
- Creams, like Estrace and Premarin, are messy, but can be useful in keeping external vaginal tissue plump and moist.
- The vaginal estrogen ring, Estring, is convenient and not messy, but might be more expensive depending on your medical coverage.
- Suppositories, like Vagifem, are less convenient than the ring, but not as messy as creams.
Rings and suppositories might not be enough if you are experiencing atrophy of the labia and clitoris (Aack!) This is why some doctors prescribe Vagifem or Estring for internal use and vaginal cream for external use.
There is no scientific evidence that herbs like Black Cohosh help at all. One study done on 350 women showed no benefit when compared to a placebo.6
Some women swear by coconut oil to relieve vaginal dryness and moisturize vaginal tissue. I must admit that it smells wonderful and makes a great sexual lubricant. But I don’t like how it can stain my sheets, so definitely use a towel. And one of the perks of menopause is that I can now buy beautiful panties. I’m not about to ruin them by getting them all greasy.
Use it or Lose it
Your vagina is a muscle that was made for sex. If you don’t use it, over time, your juicy vagina with wither away.
Why You Should Care
Women and men who have active sex lives are happier and live longer7. Why? Probably because sex is what you do when you aren’t dead. One of the sure sign-posts on the road to dead is to stop having sex.
Even a good sex life may falter as we age. Doing the same things over and over again is boring. It’s also likely your sexual partner is experiencing some changes due to aging, too. While you’re worried about your drying vagina, he may be feeling anxious about his virility.
Now is the time to get honest about who you are and what you want sexually. (Here is the controversial post I wrote about getting down and dirty after being brutally honest with my husband.).
Maybe it is time to bring some toys into the fun, or start trying the things you’ve always been afraid to try.
Don’t wait to live the life you want. You aren’t going to live forever.
- http://www.ncbi.nlm.nih.gov/pubmed/8293835 (prevalence of vaginal atrophy)
- http://www.nlm.nih.gov/medlineplus/ency/article/004016.htm (Aging changes in the female reproductive system)
- http://www.ncbi.nlm.nih.gov/pubmed/20828948 (Replens as effective as hormonal replacement)
- http://www.ncbi.nlm.nih.gov/pubmed/22942807 (Vaginal Estrogen in post-menopausal breast cancer patients)
- http://www.ncbi.nlm.nih.gov/pubmed/10810960 (Vagifem versus Premarin Vaginal Cream
- http://www.mayoclinic.com/health/vaginal-atrophy/DS00770/DSECTION=alternative-medicine (Black Cohosh ineffective in treating vaginal atrophy)