At 50 years of age, Chloe was a strikingly beautiful woman who walked with a noticeable limp, the residual effect of a stroke she had suffered at the young age of 46. She presented to my office for stress urinary incontinence, present since the birth of her last child at the age of 40. Since her stroke, Chloe had less tolerance for her leaky bladder and decided to seek treatment.
As a nurse continence advisor, I made the following recommendations:
- Drink 6-8 cups of water based fluids per day
- Distribute fluids evenly throughout the day between 9 am and 7 pm
- Conduct pelvic floor muscle exercises
- Do the “knack” with any cough or sneeze (a pelvic muscle maneuver to stop leakage)
I then asked Chloe if she experienced vaginal dryness and she did, in fact, she said that sex was painful. She attributed this to her stroke but I explained to Chloe that vaginal dryness is common as women age and this would have happened regardless of her stroke. The estrogen receptors in the vagina decrease in women from age 31 onward, and this may lead to vaginal dryness and, yes, painful sex. I explained the different available treatment options; from lubricants which would only be a temporary fix to hormone free personal moisturizers to low dose localized estrogen therapy. Chloe wanted to discuss these treatment options with her neurologist because she wondered if she was a candidate for the low dose localized estrogen. In the meantime, I suggested that Chloe try both of the hormone free options to see which type of delivery she preferred, an ovule or a gel.
One month after the initial visit, Chloe came in for her follow up visit. As I suspected, her neurologist was uncomfortable prescribing estrogen, even low dose with her history of a stroke. Chloe had tried both RepaGyn® (a hormone-free version of a personal moisturizer) and DrUAqua a cream personal moisturizer also hormone free that contains tea tree oil. Chloe chose to continue using the RepaGyn®, a hormone free ovule inserted into the vagina nightly – I recommended she use RepaGyn® once daily for two months and then twice per week. She had been using RepaGyn® for two weeks and was already feeling more moistness in her vagina.
Chloe was extremely grateful for the hormone-free option as she was extremely bothered by the fact that her intimate relationship with her husband was being interrupted. Chloe said she felt that getting her vaginal dryness treated was a stroke of luck. Feeling much better with increased sexual self esteem, Chloe was confident she would be getting back to the bedroom with the love of her life, the man who supported her in difficult times, her husband.