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Painful Intercourse After Menopause: Causes and Options

There are a number of different components that may additionally contribute to dyspareunia amongst menopausal girls. The hormonal adjustments alter acidity ranges of the vagina, Dr. Streicher mentioned, which might result in recurrent urinary tract infections amongst menopausal girls, creating discomfort within the space whether or not or not they’re having intercourse. And a few widespread well being situations amongst older individuals, like diabetes or heart problems, also can dry out the vagina, she added.

All of it relies on the diploma of adjustments to the vaginal space, Dr. Streicher mentioned, and the most secure method to decide what therapy you want is by searching for out an knowledgeable who will do an intensive examination. “There’s an enormous distinction between ‘Oh, you recognize, I’m not as moist as I often am’ versus it’s so dry, so tight and so skinny that the tissue actually splits.”

Listed below are a couple of of the therapy choices:

Lubricants: This can be a fast and simple answer for girls who are suffering solely from dryness. Dr. Streicher recommends warming the lubricant as a result of “chilly is a vasoconstrictor, which can make you will have even much less pure lubrication, whereas warmth is a vasodilator and can assist the muscle tissues loosen up,” she mentioned. One choice is inserting a bottle of lubricant in a bowl of sizzling water for a couple of minutes earlier than use.

Vaginal moisturizers: These lotions and gels will be discovered over-the-counter. “What they really do is improve water content material in vaginal mucosal cells — those which might be lining the wall,” Dr. Streicher mentioned, serving to restore their elasticity and lubrication, although they can be useful for many who have ache within the vestibule. Some moisturizers also can assist decrease vaginal pH ranges, she mentioned. Beware that many lubricants market themselves as moisturizers; the distinction is {that a} moisturizer may have directions to use it contained in the vagina regularly, Dr. Streicher mentioned, whereas a lubricant needs to be used throughout intercourse.

Estrogen lotions: Research have repeatedly discovered that this prescription choice is very efficient at lowering ache, together with within the vestibule space. They’re usually low-dose, localized and are available in numerous formulations that your physician might help you select amongst.

Lidocaine: That is an unconventional prescription choice that Dr. Goetsch has advisable for a lot of of her sufferers, notably those that can’t use hormones, like breast most cancers survivors. Liquid lidocaine is an anesthetic that numbs the nerve endings of the vestibule. In a small randomized trial in girls with dyspareunia, lidocaine diminished ache considerably throughout intimacy for many contributors, Dr. Goetsch mentioned, and ladies who had intercourse whereas utilizing lidocaine not often reported residual ache after the anesthetic wore off. And, Dr. Goetsch added, software of liquid lidocaine didn’t numb the associate.

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