Dear Chloe,
I have an embarrassing problem. I am 52, and have been happily married for 18 years. Lately my vagina seems drier than it used to be and, after sex, I’m having burning and a feeling of raw soreness. Is there something wrong with me, and what can I do about this?
Signed,
Parched in the Privates
Dear Parched,
Welcome to Part Two of the Wonderful World of Womanhood. Part One included such treats as bleeding, cramps, and childbirth. Just when you’d gotten a handle on all of that, Part Two comes along bringing with it vaginal dryness, night sweats, and chin hairs. Lucky us.
There is no reason to be embarrassed. You are not alone. Nearly one-half of all women will experience vaginal dryness due to the decline of estrogen that occurs as a result of menopause.1 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 is happening is that your plump and pretty little ovaries—which are where your estrogen is produced–are shriveling up and wasting away. Check out this super-scientific illustration that will help you visualize what exactly is happening:
Because of this ovarian atrophy, your vagina, once a verdant garden of pleasure,
can become a dried-up wasteland.
What is a girl to do?
The first step is to see your doctor and tell her what is going on.
Here’s the thing…
Patients expect the doctor to mention stuff like this, but doctors often don’t say anything about vaginal dryness because they wait for the patient to say something. If you don’t say anything then your doctor will assume that you don’t have a problem. Besides, I don’t know about you, but I don’t find a vaginal exam all that stimulating. The doctor can’t really tell during a typical exam that you aren’t lubricating during sex. She’ll just assume that you are, unless you tell her you aren’t.
After a thorough internal exam, your doctor will likely recommend one or more of the following treatments:
Vaginal Lubricants
There are several good water-based lubricants on the market today, like KY and Astroglide. Lubricants are often a good first step in treating mild vaginal dryness. 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.
Vaginal moisturizers
Replens, is a long-acting, non-hormonal vaginal moisturizer that “contains a bioadhesive that allows it to attach to dry, compacted cells and deliver continuous moisture until those cells are naturally regenerated.” You apply Replens during non-sexy-time every 3-5 days to keep your tender lady parts supple and moist, and ready for action whenever the mood strikes.
Numerous clinical trials have show that Replens is 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
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 many women are now afraid to take 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.
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 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.
- 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.
Natural Remedies
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 use natural oils like coconut or olive to moisturize vaginal tissue. I’m not a fan because oils like this are messy, and ruin your underwear.
Use it or Lose it
The truth is that your vagina is a muscle that was made for sex. Women who engage in regular sex have less chance of developing vaginal atrophy. It’s really as simple as that.
Even a good sex life may falter during middle-age. Doing the same things over and over again after so many years together can get boring. Talk to your husband. You may need more foreplay and/or something new to spice things up. Now is the time for adventure and reconnecting with your mate.
Sex not only keeps your vagina healthy, it keeps you healthier overall. People who have active sex lives are happier and live longer.7 Sex is what you do when you aren’t dead. Once you stop having sex, you are on the sure road to dead.
So, see your doctor, find the treatment that is right for you, and, please, keep having sex.
Resources:
- 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)
- http://www.healthline.com/health-feature/12-ways-sex-helps-you-live-longer
{ 50 comments… read them below or add one }
I love your the way you meet this subject head-on (I was looking for a sexual metaphor but could cum up with one.) And I love your illustrations. Especially the burning bush. xo
Shannon Bradley-Colleary recently posted..When Someone Dies Too Young
I’m not picky, I take all cummers…comers.
That illustration was pulled from a real-life moment. I think it captures perfectly the emotions we both felt when my vagina caught fire. It was no fun.
I will keep having sex, I promise!
Sharon Greenthal (@sharongreenthal) recently posted..Aging as Youthfully as We Can
Oh good. Then my work is done.
Great info! Thanks, Chloe!
Susan in the Boonies recently posted..Salmon Fish Tacos with Spicy Slaw and "Free" Fish
You’re welcome! I try to be informative. Sometimes.
How could you make something as depressing as this, funny, helpful and, well, just part of life? I am not prone to listen to bloggers on medical issues because I cannot be assured of their expertise but as I know your background, I find this very informative.
GrownandFlown recently posted..Nothing to Fear
I don’t know a lot about much, but about hoo ha’s I know more than a person should. I think I’ve seen more than Wilt Chamberlain, which is a strange thing to say, I suppose.
Ya know, this is an issue that even younger women need the FYI on. After our oldest was born, our doc told me my hormone “chaos” might cause dryness. I blew that off, assuming he just didn’t know my body like I did. *roll eyes* Painfully, I ended up buying our first tube of KY.
Oh, and THANK YOU for letting my know I’m not the only one who had a negative experience with those “enhancing” ones… one try and I couldn’t begin to understand why anyone would want to use the equivalent of vaginal icy hot!!
Kristi, I don’t understand their appeal. “Vaginal icy hot” really captures it. And if you have the delicate tissues that come from vaginal atrophy these chemicals can really hurt.
You are right, too, that other things besides menopause can cause vaginal dryness. Breastfeeding is one of those times. Or when my husband doesn’t pick up his socks and underwear. I don’t think there’s a cream or a gel for that last one though.
LOL! Too true.
As a girl who has bought more than her fair share of lubricants (14+) and at some point become allergic to them call I am going to have to hump/jump to the defense of organic Coconut oil as my natural non-irritating lube of choice.
While indeed an oil it absorbs into the skin nicely, does not have a funky chemical scent and makes you think of the beach! What more could you want from a lube?
While not right for those using most types of condoms ( oil breaks down latex) for those looking for something a bit more natural, and a secret thrill while standing in the grocery store line.. coconut oil might be for you!
Maddie Kertay recently posted..Quilting Lessons- A Painful Tale
In defense of coconut oil, I have used it for normal sexual lubricant to good effect. After my vaginal surgery, I used coconut oil because there is some evidence that KY or Astroglide can cause scar tissue. And I like that when I close my eyes I feel like I’m having sex on the beach when I use it.
But for the treatment of vaginal atrophy due to menopause, coconut oil may not be effective or last long enough in between sexual encounters.
Chloe recently posted..Your Vagina. Use it or lose it.
True enough.. I think of it as the first line of defense so that I don’t have to leave the game on a technical foul thus by staying in the games things have a chance to work on their own after a bit..but the honest truth is that since starting to have kids 23 years ago there has not been a time I have not needed or wanted to use some sort of lubricant .. it just makes things easier ( pardon the pun).. But if Atrophy is already in the house I think working your way through multiple treatment options is very worth while!
Maddie Kertay recently posted..Quilting Lessons- A Painful Tale
Coconut oil has a lot of great qualities. If you ovaries are still working then it probably is sufficient. But once those puppies start to gasp their last, you might need to bring in the bigger guns.
Chloe recently posted..Your Vagina. Use it or lose it.
What great factual info. I appreciate your work in presenting this in such a clear way.
Thank you, Ann. Hopefully is was clear and serious enough while putting it in some perspective that this isn’t the end of the world and there are good treatments out there to help.
Wonderful information. Love the illustrations. Every OB/GYN should have them laminated and keep them in their offices. (I am NOT kidding!) It just so happens I have an appt. tomorrow and I am going to mention this to my doctor. You are a treasure! (But I am not going to show this to my husband because he will definitely say, “Ya see, I told you we weren’t having enough sex!”)
mindy trotta recently posted..Cooking Matters…A Great Program!
Please do mention it. I think doctors really should ask about things like this, but for some reason they don’t. When I started to really suffer from my vaginal prolapse I had to bring it up to the doctor. She never said a word until I mentioned I was having a problem. Then she said, “Oh, yeah, you have a prolapse.” What? Why wouldn’t she bring it up? I just figured if she noticed something she’d say to me. But doctors rarely do.
Chloe recently posted..Your Vagina. Use it or lose it.
Great information. My husband will be happy to know that my vagina needs sex. We use an organic lubricant from the UK (yes, they ship to the states) from http://www.YesYesYes.org – I just love the name! In case anyone wants to know more about the company I wrote about it here; http://www.thesucculentwife.com/yes-yes-yes-certified-organic-lubricant/
audrey van petegem recently posted..Clever Find: Nora Fleming’s Interchangeable Ceramics
Husbands are generally happy to hear this information. I haven’t had too many men yet complain about that advice when I give it.
I am completely interested in this lubricant. For women who aren’t in need of the bigger guns, like moisturizers and estrogen replacement, lubricants can be a godsend.
My gyne didn’t blink an eye when I mentioned my post-menopausal parchness. She quickly wrote down the name of two lubricants and the name of the store to find them. I thanked her profusely at my next visit – or should I say, my husband sent his thanks. One good thing about “drying up” after menopause is that my hair doesn’t get as oily!
Love your illustrations.
Julie Danis recently posted..Say Maybe to No Before Yes
I think doctors are very good about helping women with these issues when the women brings it up. What doctors aren’t good about is bringing it up first.
I do like that my hair doesn’t get as oily and my face doesn’t break out anymore. Those are both big pluses to midlife.
I experienced menopause at 35 because I had to have my ovaries removed (cancer related). So this body isn’t producing any estrogen and at first my doctors suggested coconut oil but I found it to be really irritating. I’m now using a vaginal estrogen cream that helps a little (honestly, I don’t use it that often because I’m worried about the slightest amount of estrogen entering my body). My biggest beef about menopause is that I simply don’t get “hot and bothered” anymore. Will I ever feel like having sex again? Le sigh.
Wendy recently posted..Breast Cancer 101: BRCA Gene Mutation
Wendy, I’ve been thinking about your comment all day.
I did some research and it seems Estring is your safest option. It is the vaginal estrogen treatment that results in the lowest circulating levels of estrogen. The libido thing? That’s a tough one. I did some looking up about testosterone, but see that it carries the same concerns that estrogen does. I promise I will think on your issue though and if I come up with any answers I will let you know.
Chloe recently posted..Your Vagina. Use it or lose it.
Great post, I plan to post it on my blog as a reference-when I figure out where and how I want to do that. You offer the right blend of ‘light’ and informed. I’m not having this issue yet (age 58 and 3 yrs. past menopause), but like any woman there are dry times so I keep a bottle of lube nearby at all times. And, I practice regular sex…as often as I can!
Walker recently posted..Women’s Sexual Enhancement Products-It’s Our Turn
Hey Walker, nice to meet you.
Most of the articles I read on this for my research were as a dry as an old vagina. I hope that women can read this and feel there is both humor and hope for them.
Thanks for stopping by. If you find a place for it, that would be great.
Your illustrations are fantastic. You should do a children’s book.
Ginger recently posted..Stop Wearing Granny Panties
Thank you, Ginger. I’m not sure a children’s book on inflamed vaginas is in my future, but it would serve that 4th grade teacher, who told me I wasn’t an artist, right if one day my art was published in a book. I totally want to do that now.
Very helpful information. No problem in the using it area, we just buy the lube in bulk these days
Next topic libido ???
Molley Mills recently posted..Culinary Fail – It Happens to Us All
Hey Molley,
Libido is a great topic! I definitely think we all need some advice on that from time to time since there’s no such thing as Viagra for women and I doubt there ever will be.
“Sex is what you do when you aren’t dead.”
Damn. And I thought it was shoe shopping.
xoxo
Fabulous post!
BigLittleWolf recently posted..Kate’s Boobs
Well, shopping too. And I’ve had some great shopping trips, but still. When my mother was dying in our house, my husband and I made love in the room across the hall. It was the most bittersweet and life-affirming thing we could have done. And since my mother’s very last written words were, “Oh, Glorious Sex. I’m glad I found you!” I knew she’d approve.
LOVE the illustrations. And the honest discourse.
Hey Pamela. Thank you! I live for my art.
Once you stop having sex you’re on the sure road to dead. Yes, yes, yes – in so many ways! Thanks for an informative post. I have coconut oil that I’ve been using on hands and feet – I’ll try it closer to my middle now – the closing my eyes and imaging the beach is an added bonus.
Barbara recently posted..on saving a grown child
If you aren’t having problems now then definitely start lubricating to ward off future problems.
I think sex is so important in so many ways. We should fight for our sex lives and be loathe to give them up.
It’s so nice to see a dry *ahem* topic covered in a humorous manner! I really don’t understand why doctors don’t have a checklist for women having their annual visit — dryness, frequency, the big O, menstrual cycle regularity, blah blah blah. It would make things so much easier than guessing what needs to be told to the dr.
Oh, and I loved the illustrations, particularly the burning bush one!! LOL
I don’t understand it either. It is understandable why women are embarrassed to bring up these topics, but I think it is near negligence that doctors don’t feel more comfortable addressing common female concerns.
But then I’ve read some women complain and feel that their doctors were too nosy. So I guess doctors feel caught and unsure if their patient is open to talking about this or will become offended.
My estrogen cream is my secret weapon for those little abrasions that happen from vigorous sex but due to my suppressed immune system, don’t heal on their own.
Great post, Chloe.
Estrogen cream is most excellent. I swear by it.
Chloe Jeffreys recently posted..Owning It in 4 Easy Lessons
Great info. Thank you. I *love* your illustrations. Now any time I think of (or consider) those “new sensation” products, I’ll surely imagine flames engulfing my vagina.
Lisa @ Grandma’s Briefs recently posted..I would do anything for love (but I won’t do that)
Lisa, you might have better luck than me, but I advise serious caution with these sorts of products. It is like sticking a piece of chewed Big Red into your delicate lady parts. Not fun.
Chloe Jeffreys recently posted..Owning It in 4 Easy Lessons
Oh yes, we are destined to be friends, you Vagina Whisperer, you! In fact, I can’t believe we haven’t met yet! Some of my friends call me the Queen of Vagene. (And I like it.)
So, hello Chloe! So nice to meet you. Love your illustrations and ability to discuss important topics like this. I’ll be back!
The Bearded Iris recently posted..Does a Kegel a day keep the transvaginal mesh away?
Hey!! I’ve been out of town and just got back to this. You and I are kindred spirits. I am soooo glad to meet you.
Chloe Jeffreys recently posted..Owning It in 4 Easy Lessons
I laughed at the pics so hard I cried. Verdant playground…bwahaha. Tucking this info away for when I hit 50 next year or whenever I need it. (Hopefully never).
Hey, Lisa, Thanks for stopping by. It happens more quickly than you realize. I love my vaginal estrogen. I’m a big, big fan!
You won’t believe how I found this blog (was Googling for a photo of soup and saw your Virus-Killing Concoction), but of course I had to click on the “Vagina Whisperer” tab once I was here. This is very timely advice since I will be turning 49 next month and am definitely going through perimenopause already! I know perfectly well that a lack of natural lubricant is probably in my future (ugh), so learning more on this topic is valuable.
I do have a question, though: as a horse person, I have a bit of an issue with Premarin. Is there a synthetic estrogen cream that works as well? I am not totally adverse to taking an oral replacement (cancer doesn’t run in my family, thank God) but the cream thing sounds better so I’d love to get your opinion. Thanks!
*heads off to look around the rest of the blog*
I know this health problem create complication is sex life so it’s better to overcome from this as quick as possible.
russell recently posted..Understanding the Types of Premature Ejaculation
I have a problem but I don’t think it could i get cream get fix its vagina dryness.do I to get any cream to help the situation?
I need help.can u please help me.is it normal?
Shanice recently posted..Just Call Me Mrs.Judgy McJudgypants