Is sex painful???? - Ellen Dolgen
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 Is sex painful????

You can’t outsource menopause –  it is a total brain and body event and YES it can affect your sex life.

Are you are experiencing physical pain with intercourse during menopause?

The medical term for this painful intercourse is dyspareunia. I know— quite the bizarre word!!!  You may hear other medical terms like vulva vaginal atrophy (VVA) which is a component of the genitourinary syndrome of menopause (GSM). It’s just us girls here so let’s refer to these symptoms as dry vagina, painful sex, or vaginal atrophy (VA).

Vaginal atrophy is just that: a thinning (and inflammation) of the vaginal wall. VA occurs when there’s a drop in levels of estrogens, produced by the ovaries. Estrogens maintain the structure and function of the vaginal wall, the elasticity of the tissues around the vagina, and the production of vaginal fluid. When it comes to the vagina, thin and dry is out!

We seem to hear more about hot flashes, sleeplessness, and memory loss — but vaginal discomfort is every bit as difficult and critical to deal with as other menopausal symptoms. Vaginal symptoms can negatively impact not only your relationships and sexuality but can affect your quality of life and self-image.   Most women don’t even know what VA is, nor understand that it is a chronic problem that requires ongoing treatment and IS treatable.

What are the symptoms of VA?

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

If you feel you’re left high and dry, you’re not alone. Between 17 and 45 percent of postmenopausal women say they find sex painful, according to The Menopause Society.

The Menopause Society notes that pain during sex (or simply the fear of pain during sex) can trigger performance anxiety or arousal problems in some women. This also can diminish lubrication or cause involuntary — and painful — tightening of the vaginal muscles, called vaginismus. It’s a vicious vaginal cycle.

Sadly,  38% to 56% of postmenopausal women have never discussed these symptoms with their healthcare providers!  The reason is they are uncomfortable and believe it is something they have to live with as they age.  In addition, women are unaware that there are successful ways to treat this condition.

Here are a few options to discuss with your menopause specialist:

  • Try pelvic floor therapy.  This is a safe and effective — technique that has helped many of my subscribers. A physical therapist uses massage and gentle pressure to relax and stretch tightened tissues in the pelvic area. Your therapist may also give you exercises to help strengthen your pelvic floor muscles, which may have been weakened by aging, childbirth, or hormonal changes. Learn more about pelvic floor therapy in this Menopause Mondays® Hot News Flash.
  • A little personal lubricant or moisturizer can go a long way in the bedroom. However, your vagina may need more than a lube job. Non-hormonal vaginal lubricants can help decrease friction and discomfort during intercourse. Be sure that they are water-based and designed for vaginal use. Petroleum-based lubricants can harbor bacteria in the vagina and lead to infection, as well as damage latex condoms. Vaginal moisturizers (similar to moisturizing your face (most women find these helpful to use every day) can help relieve dryness and rebalance the acidity of the vagina. Both lubricants and moisturizers provide temporary relief of symptoms but do not treat the underlying condition of vaginal atrophy.
  • If you’re lubed to the max and still have no relief, see your menopause specialist. If you don’t have one, you can find some helpful tips here.
  • Ask your specialist for a pelvic exam of the vagina and cervix and a Pap test to take a sample of cells from the cervix. Also, have your vaginal secretions and the acid level in your vagina checked. You may need to provide a urine sample if you’re experiencing unusual urgency or a leaky bladder.
  • Hormone treatment options include local estrogen therapy (LET) and systemic estrogen therapy. LET is estrogen applied directly to vaginal tissues, so it goes directly to the affected area, with minimal absorption of estrogen into the bloodstream. LET is available in creams, a ring, and a tablet. Systemic hormone therapy (HT) allows estrogen to circulate throughout the bloodstream to all parts of the body.  It’s available in many forms: a pill, injection, patch, gel, and spray. Systemic HT is most often prescribed for multiple whole-body symptoms of menopause, including night sweats, hot flashes, and others. Some women need a combination of treatments.
  • Some women use vaginal DHEA tablets.
  • Communicate with your partner. Honesty is definitely the best policy. If you’re avoiding sex due to pain, your partner could misinterpret it as your dissatisfaction with the relationship (or the sex).

It’s been years since my vagina found itself stranded on a desert island and took my sex drive with it! At different stages of my menopausal life, I have had to tweak my protocols. However, since rescuing my stranded vag, my life is full, happy, and satisfied. Remember: Your symptoms are treatable. You can have a happy, healthy vagina again!

The big “O” does not mean “the big Ouch.” Recapture the rapture in bed.

My motto: Suffering in silence is OUT! Reaching out is IN! 

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