Painful sex & menopause

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  • Natural menopause is the cessation of menstruation. 
  • Surgical menopause is the result of the surgical removal of both ovaries(oophorectomy), often a component of total hysterectomy.
  • Induced menopause is the results of certain medications that stop ovarian (estrogen) production, i.e. Lupron injections for the treatment of endometriosis or breast cancer. 
  • Menopause can also occur as the result of  pelvic/vaginal radiation for cancer.
  • Postmenopause is defined as the woman's stage of life after menopause, starting 2 years after her last period and going forward.

 Women's Therapy Center

The declining estrogen levels from menopause onward have a profound effect on the vagina, making it thinner, less elastic, drier, and more prone to chafing irritation & bleeding.  These are inevitable outcome that all women experience.

The functional outcome of  these changes include

  • Feeling dry, pinchy, chaffy
  • The genital lips may 'stick together'
  • Insufficient natural lubrication
  • Intercourse is progressely uncomfortable/painful (dyspareunia)
  • Intercourse is no longer possible (secondary vaginismus)
  • Gyno exams are progressively difficult or no longer possible (secondary vaginismus)
  • Urinary frequency and urgency -- the lower 1/3 of the vagina and the urethra share a common wall that is equally affected
  • Emotional and relationship distress
  • For the single woman -doubts about dating: "who would want me without intercourse?"
  • Loss of sexual interest (libido)

Some environmental factors may compound the problem:

  1. Dry indoor heat in cold climates
  2. Insufficient hydration (drinking)
  3. The drying effect of certain medications, including those for allergies
  4. Excessive hygiene, including hot water on the genitals - read our blog about it

The good news is that a sound restorative program should allow most menopausal and postmenopausal women to resume vaginal functions with little or no disruption.  You can liken the aging vagina to an old baseball glove that needs oil rubbed in to restore its shape, softness, elasticity and function.

It is important to remember that each woman will have her own particular needs but, generally speaking, the following components sum up the essence of a sound restorative program:

  • Vaginal estrogen cream
  • Vaginal moisturizer
  • Vaginal lubrication for penetration
  • Pentration re-training using dilators
  • Environmental adjustments
  • Psychotherapy

The sad news is that medical and public awareness about the menopausal & postmenopausal vagina is poor, forcing women to accept the limitations as inevitable and to suffer in silence.  

We hope that you will not only take care of your vagina during these life phases, but also share this webpage with your friends and healthcare provider/s -- spread the word!

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