I'm going through menopause and I feel like my vagina is dry and irritated. Intercourse and oral sex are so painful! What can I do

Q:

I'm going through menopause and I feel like my vagina is dry and irritated. Intercourse and oral sex are so painful! What can I do?

A:

Dryness is more common than not and should be addressed from the inside out. You want to look at all possible resources to find one that works best with your body. When estrogen declines with menopause, it causes a decrease of blood flow to the vagina which results in a change in lubrication. It takes more time to become lubricated and there may be less natural lubricant than you may need for sexual activity. Be flexible when it comes to finding solutions. I would start with a lubricant that you can use during self-stimulation, partnered activity, and on a regular basis as a barrier against friction. Most quality lubricants have base oils such as coconut, jojoba, almond and hemp oil that soothe irritation from dryness and have healing benefits for the skin. (Note that oil-based lubricants can degrade latex condoms, though.) There are also products such as vaginal moisturizers that are designed to be used like a face cream. They help moisturize the vaginal tissue and reduce the discomfort from dryness. The moisturizers are absorbed into the tissue and increase moisture in the surrounding area by plumping up the tissue. Look for products that contain natural moisturizing ingredients such as vitamin E and aloe vera. Avoid products with harsh chemicals and ingredients that can irritate sensitive tissue. Vitamin E also comes in vaginal suppositories that can be placed in the vagina at night before bed.

Hormone replacement therapy is an option and should be evaluated and discussed with a specialized healthcare provider. Not all hormone creams or supplements will eliminate vaginal dryness, so you may need to experiment with different types to see how your body responds. The hormones will help reduce symptoms and provide relief from sexual discomfort.

It’s important not to avoid all physical contact when dealing with dryness. Using a vibrator or personal massager can help increase blood flow to the vaginal area, which can help maintain the lubrication process. It also helps keep the tissue healthy to avoid vaginal atrophy, which is when the walls of the vagina shrink and become thinner due to loss of estrogen.

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Written by Dr. Shannon Chavez
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Dr. Shannon Chavez is a licensed clinical psychologist and sex therapist with an expertise in female sexual health. She works with women and couples of all ages and backgrounds helping guide them from sexual concerns to sexual empowerment. She currently has a private practice in Beverly Hills, California, and uses a mind-body approach to sexual health wellness and a treatment approach that integrates both physical and psychological needs.

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