I have had countless emails this season from many women confused about treatment options for their vaginal dryness and/or vaginal atrophy. Many have been frustrated with their doctors who have either provided no solutions or limited ones. All of these women have noted how drastically vaginal dryness and/or vaginal atrophy has impacted their sex lives and it did not look like 2016 would start out with a bang! Vaginal dryness and/or vaginal atrophy can happen suddenly or gradually over time. These women I am referring to are all youthful and vibrant, some self described as “very sexual,” some in long term relationships, others in new relationships where the sex was hot and then suddenly was not!
Virginia’s Vaginal Dryness
Virginia went to her doctor for vaginal dryness and was told that she was getting older and she should expect things to dry up! She was 48! Never, I said. Women do not have to live this way! For this lady, who was also experiencing clitoral and labial dryness, and was anxious to resume her sex life with her husband, I recommended she try a personal moisturizer in the form of an ovule inserted into the vagina and then add either a cream or gel for her clitoris and labia. Here are some natural choices:
- RepaGyn® (ovule formulation; contains hyaluronic acid for tissue repair and moisturization)
- Gynatrof® (gel formulation; contains hyaluronic acid for tissue repair and moisturization)
- Joy Gel (gel formulation; contains yam, a natural source of estrogen and coconut oil to keep tissues youthful)
- DrUAqua (cream formulation; contains Vitamin E for youthful tissues and Tea Tree Oil for a nice scent)
I suggested that she refrain from penetrative sex for two weeks to allow time for the personal moisturizer to begin to work at repairing the dry and thin vaginal tissues. That said, kissing, touching, fondling, and having fun otherwise would be fine and may help to naturally increase lubrication. Optimization of the personal moisturizer would take two months but relief could begin to occur very quickly (within days or weeks for some).
Abbey’s Vaginal Atrophy
Abbey emailed me because she was not able to have sex at all; penetration alone was so painful. Her new boyfriend could not get past her introitus (vaginal opening) and she also noted that she had thin, watery discharge and was getting recurrent urinary tract infections. Her labia was also quite dry which was cause for distress. I suggested that she see her family doctor or a Gynaecologist because she would need to have an internal examination. She had all the symptoms of vaginal atrophy, a condition associated with decreased estrogen receptors in the vagina. This is a common condition at midlife and for women who are on the pill or breastfeeding.
Vaginal atrophy may occur if vaginal dryness is not properly managed or treated. The treatment for vaginal atrophy is low dose localized estrogen (available as a tablet, cream or a ring) inserted into the vagina, and remains in place for 3 months, delivering steady low doses of estrogen. This is not the same as the systemic estrogen that is used for menopausal symptoms like hot flashes and night sweats. What would likely be beneficial would be what is known as the “three-pronged” approach which consists of:
- Low dose localized estrogen therapy (LET) twice weekly
- Personal moisturizer (like RepaGyn® for tissue healing and moisturization/lubrication) on opposite days of LET
- Vaginal dilators
Once Abby’s vaginal and labial tissues were more moist and supple, she could begin to use vaginal dilators to open her introitus which will ease penile penetration.
Following these simple recommendations will surely get women like Abbey and Virginia back to the bedroom so they can start the New Year off with a bang!