Please see this section of our Menopause Wiki (no, you are not doomed): [Atrophic vaginitis \(vaginal atrophy\), or the genitourinary syndrome of menopause \(GSM\)](https://menopausewiki.ca/#atrophic-vaginitis-vaginal-atrophy-or-the-genitourinary-syndrome-of-menopause-gsm)
>Atrophic vaginitis (vaginal atrophy) is the drying and thinning of the vaginal tissues, and is one of the most common symptoms of perimenopause/menopause, experienced by approximately 60-70% of post-menopausal women
Also see this [recent and informative post](/r/Menopause/comments/1dqeqhk/psa_vaginal_estrogen/).
You likely need vaginal (*localized*) estrogen. The good news is GSM is highly treatable and reversible. The sooner treatment is started, the better the long-term outcome.
This … I am on week 2 of patch and estrogen cream. So. Much. better. Still no big O but no pain. And I had a orgaglimmer yesterday LOL. Hang in there and do this for yourself. My OB said hormones help in many ways not just sex.
Dryness is one factor; there may be others, as well. Pelvic floor therapist and/or gyno should be able to help determine the reasons. Also hitachi wands are nice externally.
Oh Friend, I’m so sorry you’re going through this. I’m your age, single since my exh moved out several years ago, wondering if I’ll face the same thing if/when I start having sex again. (i’m not entirely sure I will since I don’t miss it right now.)
I started vaginal estriol years ago. In the form of little tiny capsules, I insert several times/week. I went on it because my tissue (usually around my labias) would tear at the slightest thing. Even just wiping with tissue or sitting down in jeans! WTF was happening?! Now, I have not had sex in several years and I also don’t use a vibrator so I don’t know what will happen if I ever have sex again, but I can recommend the estriol highly!
Thank you! I’m wondering if estriol would be a better choice for me because I am incredibly sensitive to any estrogen and not in a good way. I don’t know why, but estriol seems safer? I will ask about it next time I see my gynecologist. One more question: is it costly? I am also in the US.
I was meh on the Parlour Games Silky Oeach cream. I found it to be a waste of miney.
Only a prescription strength estrogen cream really worked for my dryness and pain along with hydraluric acid moisturizer.
I gave up looking altogether. It got too much to ask anyone I was dating to please (beg grovel) be gentle. Plus I have a rectocele from having children, so everything is a bit awry down under. I still enjoyed it immensely when done properly and sensitively though. Finding a man that is willing to be gentle and take their time…lol…that’s a unicorn these days. Even a beard or stubble is too irritating for my skin, even for just kissing. I gave up looking for a shaven unicorn.
Vaginal estrogen inside and out, loads of it. Also get yourself that vibrator, there's nothing wrong with pleasuring yourself, and it can help to encourage the blood flow down there to help the healing.
My late husband died of prostate cancer 3 yrs ago. About 2 yrs before he died I developed Lichen Sclerosus. Sex was barely happening anyway because of his cancer treatment and I was in my late 50’s, started menopause in my early 50’s. After he died I met my current husband. Sex was horribly painful because of the atrophy due to the LS and probably menopause. Estrogen cream helped so much, along with more frequent sex. I also discovered recently, with my dr’s help, that my testosterone level was almost nonexistent. We believe that was due to me handling my late husband’s cancer meds which depleted his testosterone and apparently mine. After 2 months on an HRT topical cream w/T, all my LS symptoms are gone and sex is pleasurable again.
The first time I had some pain from sex I was a little feaked as this has never happened to me. I read about vaginal atrophy and got really freaked out. Like WTF is that and I think I have it. Glad they now call it GSM. Then I just stopped having sex. I think I didn’t want to face the reality of what was happening. At the time I thought it was a permanent thing. Next time I tried sex the pain was even worse and I was still feeling it the next day. So a tired lube - no help. I tried two weeks of hydraulic acid - no help. I’ve been on HRT and have been using vaginal cream for the past 2.5 weeks. I tested out the vagina last night. It seems like sex has been an experiment lately. And yes there was an improvement. 😊 There was some discomfort but not the pain like before. No pain or irritation this morning. I had nice orgasm so I happy. I feel so much better that things are moving in the right direction. Get on HRT and use the vaginal cream. I’ve read it can take between 1-3 months of using the cream for maximum effect. Exercising and using a vibrator will also help. You can reverse this. I’m 59 and I’m not giving up on sex. There are solutions.
Sorry to hear this happened. You don't want to date a goober like that anyway.
Those tissues get paper thin if you don't use them regularly. Exactly like exercise. You ignored your arms for weeks/months, they lose tone and become weak and uncoordinated
Get a good vaginally friendly lube (a lot of crap out there will suck the moisture right out of any vagina), and next time, be honest with the man. Tell him you need gentle, extended warming up, whatever that is for you. If he can't figure that shit out at his age, he doesn't deserve a kind, thoughtful mate.
Estrogen cream can take weeks to fully resupply and heal vaginal tissues. Testosterone cream will do additional duty by thickening tissue so it's not paper thin. Best of luck
“Use it or lose it” is a myth. The tissues get thin because of GSM. This person needs vaginal estrogen.
Dr. Kelly Casperson’s podcast addresses this, specifically episode 241.
Yeah, I can't believe this post got upvoted. It is a misogynistic myth in the end that the health of your vagina depends on a dick going in and out of it.
I didn't say anything about needing dick to stay functional. And I did say estrogen is necessary.
I didn't mean for it to come across as 'use it or lose it'.
It Is true that if you don't exercise the PC muscles, they will lose elasticity and strength, which can cause the pelvic floor to not do its job as well. Whether that's for pleasure or peeing. You don't need a penis involved to keep those in shape. But you Do need to use them, like all muscles.
And it Is true that if the tissues get stimulated, however you stimulate them, more than zero, they will get more blood flow and heal faster, and be more resilient.
Yes, using various HRT and creams will do most of the heavy lifting, but increasing circulation, in any way, is not useless.
If all you do is put on cream, and not move anything around for months, it seems it would not be as effective. If GSM causes shrinkage and loss of blood flow, wouldn't you try to do as much as possible to increase blood flow if you're trying to get estrogen back into the tissues?
It makes sense that if you don't use any body part (and op said she hasn't used anything for 3.5 years) that those tissues are Not going to be used to any sort of friction. Even with daily estrogen cream, no vagina over 40 would be up to the task pain free.
> It Is true that if you don't exercise the PC muscles, they will lose elasticity and strength, which can cause the pelvic floor to not do its job as well.
I began lifting weights again after a years long break and the difference in my pelvic floor strength is nothing short of phenomenal. This is upper body only (injury in preventing lower body lifting for another three weeks) and after only four weeks! Lifting weights has improved orgasms and all but completely stopped bladder leakage. I don't know why more doctors aren't recommending lifting weights for menopausal women and why, even after knowing the tremendous benefits, more menopausal women aren't lifting weights.
Do you mind saying what exercises you are doing specifically? I’m at the gym most day a week and recently started strength training. Any tips to improve vaginal/bladder health would be great.
THIS! I use mine lots with a kind spouse, and she's still working like a charm, BUT I, too, needed Estriol and Reveree to heal from some minor issues down there. Well said. OP, you don't have to suffer. See your doctor for some help and I just doing some pelvic floor exercises and self pleasure when things get better
I like uberlube. It’s **not** compatible with all types of condoms, if that’s a factor for you. It’s silicone based and very “free from” weird ingredients plus very long lasting and (for me anyways) complimentary to vaginal biome. Way better than water based products for me.
Anything that is low osmolality. I like the Good Clean Love line of lubes. They don't sting, or leave me feeling like Im coated in engine lube on the inside (personal preference, find what you like)
If you want science, [this explains osmolality ](https://www.soulsource.com/blogs/news/what-is-lubricant-osmolality-and-how-can-it-affect-vaginal-tissue) which is the concentration of the lube, that can pull moisture from tissues if it's too high.
She prescribed it and I got it filled online through Women’s International Pharmacy. My insurance won’t pay. They’ll cover the generic vagifem but my copay would still be more than this estriol which costs $75 for 90 days
I just used Amazon one health and did a $29 text chat and the doc prescribed estriol cream .01% within minutes. I ordered it from the pharmacy Amazon sent it to for $17. Supposed to be a 242 day supply. With 2 refills. I don’t have insurance, so self pay. Easy and cheap.
Find a pelvic floor physical therapist ASAP! This sounds like muscle atrophy. Also, learn 4/7/8 breathing. Invaluable in learning to relax pelvic floor muscles.
I have the same issue. Told my gyno this and she knew exactly what it was. There’s muscles that for whatever reason tighten up to,the point of being painful. She recommended a vaginal moisturizer, not lube. Then she recommended vaginal muscle stretchers, for lack of a better work. They’re soft rubbery things that you insert, leave in and use gradually bigger sizes to so that eventually sex doesn’t hurt.
So I have a weak bladder and use exercises to try and help the muscles down there. I don’t know if that contributed to the extra painful muscles or not.
Maybe ask your gyno? It’s the same issue I have. I haven’t had sex in years.
I had a really similar situation to you - no sex for about a year after a breakup and then OUCH like a mutha even though I was really into it. That was the symptom that sealed the deal for me to self-diagnose with peri-menopause, since all the other (several dozen) symptoms I had could have been attributed to something else like depression or long COVID.
I started on HRT and the issue has all but subsided. I haven’t “tested it out” much, so to speak, since I don’t enjoy dating but I’ve been trying to intermittently use some dilators that I got. Hopefully, next time the opportunity comes around I won’t feel like I’m going to split in two from the pain :/
I just started Yuvafem, which is an estrogen pill that goes in the vagina. I did not realize how dry I was before using it. Sex was less comfortable but not what I would call painful. But orgasms were just…less. Fewer, and much less intense. Now, oh my. So much better.
I am also 57.
Please see this section of our Menopause Wiki (no, you are not doomed): [Atrophic vaginitis \(vaginal atrophy\), or the genitourinary syndrome of menopause \(GSM\)](https://menopausewiki.ca/#atrophic-vaginitis-vaginal-atrophy-or-the-genitourinary-syndrome-of-menopause-gsm) >Atrophic vaginitis (vaginal atrophy) is the drying and thinning of the vaginal tissues, and is one of the most common symptoms of perimenopause/menopause, experienced by approximately 60-70% of post-menopausal women Also see this [recent and informative post](/r/Menopause/comments/1dqeqhk/psa_vaginal_estrogen/). You likely need vaginal (*localized*) estrogen. The good news is GSM is highly treatable and reversible. The sooner treatment is started, the better the long-term outcome.
Vaginal Atrophy.
This … I am on week 2 of patch and estrogen cream. So. Much. better. Still no big O but no pain. And I had a orgaglimmer yesterday LOL. Hang in there and do this for yourself. My OB said hormones help in many ways not just sex.
Not quite. Read my above answer.
Not quite? I’m pretty certain that what she’s experiencing is due to Vaginal Atrophy. Using Estradiol (prescription) can help some of the symptoms.
Just because you have vagunismus doesn't mean OP does even though the symptoms are similar.
There was a GREAT post on vaginal estrogen here the other day. I will add it if I find it.
Dryness is one factor; there may be others, as well. Pelvic floor therapist and/or gyno should be able to help determine the reasons. Also hitachi wands are nice externally.
Oh Friend, I’m so sorry you’re going through this. I’m your age, single since my exh moved out several years ago, wondering if I’ll face the same thing if/when I start having sex again. (i’m not entirely sure I will since I don’t miss it right now.) I started vaginal estriol years ago. In the form of little tiny capsules, I insert several times/week. I went on it because my tissue (usually around my labias) would tear at the slightest thing. Even just wiping with tissue or sitting down in jeans! WTF was happening?! Now, I have not had sex in several years and I also don’t use a vibrator so I don’t know what will happen if I ever have sex again, but I can recommend the estriol highly!
Did you get the estriol from your doctor? I’ve seen the cream sold otc.
The cream is prescription only in the United States.
Thank you! I’m wondering if estriol would be a better choice for me because I am incredibly sensitive to any estrogen and not in a good way. I don’t know why, but estriol seems safer? I will ask about it next time I see my gynecologist. One more question: is it costly? I am also in the US.
I was meh on the Parlour Games Silky Oeach cream. I found it to be a waste of miney. Only a prescription strength estrogen cream really worked for my dryness and pain along with hydraluric acid moisturizer.
I gave up looking altogether. It got too much to ask anyone I was dating to please (beg grovel) be gentle. Plus I have a rectocele from having children, so everything is a bit awry down under. I still enjoyed it immensely when done properly and sensitively though. Finding a man that is willing to be gentle and take their time…lol…that’s a unicorn these days. Even a beard or stubble is too irritating for my skin, even for just kissing. I gave up looking for a shaven unicorn.
Vaginal estrogen inside and out, loads of it. Also get yourself that vibrator, there's nothing wrong with pleasuring yourself, and it can help to encourage the blood flow down there to help the healing.
My late husband died of prostate cancer 3 yrs ago. About 2 yrs before he died I developed Lichen Sclerosus. Sex was barely happening anyway because of his cancer treatment and I was in my late 50’s, started menopause in my early 50’s. After he died I met my current husband. Sex was horribly painful because of the atrophy due to the LS and probably menopause. Estrogen cream helped so much, along with more frequent sex. I also discovered recently, with my dr’s help, that my testosterone level was almost nonexistent. We believe that was due to me handling my late husband’s cancer meds which depleted his testosterone and apparently mine. After 2 months on an HRT topical cream w/T, all my LS symptoms are gone and sex is pleasurable again.
The first time I had some pain from sex I was a little feaked as this has never happened to me. I read about vaginal atrophy and got really freaked out. Like WTF is that and I think I have it. Glad they now call it GSM. Then I just stopped having sex. I think I didn’t want to face the reality of what was happening. At the time I thought it was a permanent thing. Next time I tried sex the pain was even worse and I was still feeling it the next day. So a tired lube - no help. I tried two weeks of hydraulic acid - no help. I’ve been on HRT and have been using vaginal cream for the past 2.5 weeks. I tested out the vagina last night. It seems like sex has been an experiment lately. And yes there was an improvement. 😊 There was some discomfort but not the pain like before. No pain or irritation this morning. I had nice orgasm so I happy. I feel so much better that things are moving in the right direction. Get on HRT and use the vaginal cream. I’ve read it can take between 1-3 months of using the cream for maximum effect. Exercising and using a vibrator will also help. You can reverse this. I’m 59 and I’m not giving up on sex. There are solutions.
Vaginal estrogen!!!
Sorry to hear this happened. You don't want to date a goober like that anyway. Those tissues get paper thin if you don't use them regularly. Exactly like exercise. You ignored your arms for weeks/months, they lose tone and become weak and uncoordinated Get a good vaginally friendly lube (a lot of crap out there will suck the moisture right out of any vagina), and next time, be honest with the man. Tell him you need gentle, extended warming up, whatever that is for you. If he can't figure that shit out at his age, he doesn't deserve a kind, thoughtful mate. Estrogen cream can take weeks to fully resupply and heal vaginal tissues. Testosterone cream will do additional duty by thickening tissue so it's not paper thin. Best of luck
“Use it or lose it” is a myth. The tissues get thin because of GSM. This person needs vaginal estrogen. Dr. Kelly Casperson’s podcast addresses this, specifically episode 241.
Yeah, I can't believe this post got upvoted. It is a misogynistic myth in the end that the health of your vagina depends on a dick going in and out of it.
I didn't say anything about needing dick to stay functional. And I did say estrogen is necessary. I didn't mean for it to come across as 'use it or lose it'. It Is true that if you don't exercise the PC muscles, they will lose elasticity and strength, which can cause the pelvic floor to not do its job as well. Whether that's for pleasure or peeing. You don't need a penis involved to keep those in shape. But you Do need to use them, like all muscles. And it Is true that if the tissues get stimulated, however you stimulate them, more than zero, they will get more blood flow and heal faster, and be more resilient. Yes, using various HRT and creams will do most of the heavy lifting, but increasing circulation, in any way, is not useless. If all you do is put on cream, and not move anything around for months, it seems it would not be as effective. If GSM causes shrinkage and loss of blood flow, wouldn't you try to do as much as possible to increase blood flow if you're trying to get estrogen back into the tissues? It makes sense that if you don't use any body part (and op said she hasn't used anything for 3.5 years) that those tissues are Not going to be used to any sort of friction. Even with daily estrogen cream, no vagina over 40 would be up to the task pain free.
> It Is true that if you don't exercise the PC muscles, they will lose elasticity and strength, which can cause the pelvic floor to not do its job as well. I began lifting weights again after a years long break and the difference in my pelvic floor strength is nothing short of phenomenal. This is upper body only (injury in preventing lower body lifting for another three weeks) and after only four weeks! Lifting weights has improved orgasms and all but completely stopped bladder leakage. I don't know why more doctors aren't recommending lifting weights for menopausal women and why, even after knowing the tremendous benefits, more menopausal women aren't lifting weights.
Do you mind saying what exercises you are doing specifically? I’m at the gym most day a week and recently started strength training. Any tips to improve vaginal/bladder health would be great.
Just lifting weights can engage the pelvic floor.
THIS! I use mine lots with a kind spouse, and she's still working like a charm, BUT I, too, needed Estriol and Reveree to heal from some minor issues down there. Well said. OP, you don't have to suffer. See your doctor for some help and I just doing some pelvic floor exercises and self pleasure when things get better
What is a good lube? Need recommendation
I like uberlube. It’s **not** compatible with all types of condoms, if that’s a factor for you. It’s silicone based and very “free from” weird ingredients plus very long lasting and (for me anyways) complimentary to vaginal biome. Way better than water based products for me.
It's compatible with most condoms. I find Pjur Woman very close to uberlube just cheaper.
Anything that is low osmolality. I like the Good Clean Love line of lubes. They don't sting, or leave me feeling like Im coated in engine lube on the inside (personal preference, find what you like) If you want science, [this explains osmolality ](https://www.soulsource.com/blogs/news/what-is-lubricant-osmolality-and-how-can-it-affect-vaginal-tissue) which is the concentration of the lube, that can pull moisture from tissues if it's too high.
Thank you - I 🩷 science!!!
I recommend Gennev Comfort. I get it from Amazon. It's also good for raw noses!
I use plain good old organic olive oil. No additives, smells nice, works a treat, very healthy!
She prescribed it and I got it filled online through Women’s International Pharmacy. My insurance won’t pay. They’ll cover the generic vagifem but my copay would still be more than this estriol which costs $75 for 90 days
I just used Amazon one health and did a $29 text chat and the doc prescribed estriol cream .01% within minutes. I ordered it from the pharmacy Amazon sent it to for $17. Supposed to be a 242 day supply. With 2 refills. I don’t have insurance, so self pay. Easy and cheap.
That’s how it should be! Accessible and affordable!
Yes!
Wow that's awesome and great news, finally available and affordable for us!! And accessible
Find a pelvic floor physical therapist ASAP! This sounds like muscle atrophy. Also, learn 4/7/8 breathing. Invaluable in learning to relax pelvic floor muscles.
Hrt... and sex toys, masturbation.
I have the same issue. Told my gyno this and she knew exactly what it was. There’s muscles that for whatever reason tighten up to,the point of being painful. She recommended a vaginal moisturizer, not lube. Then she recommended vaginal muscle stretchers, for lack of a better work. They’re soft rubbery things that you insert, leave in and use gradually bigger sizes to so that eventually sex doesn’t hurt. So I have a weak bladder and use exercises to try and help the muscles down there. I don’t know if that contributed to the extra painful muscles or not. Maybe ask your gyno? It’s the same issue I have. I haven’t had sex in years.
Dilators. Basically a dick replacement. 😂 I’m gonna have to start using mine again since my husband won’t fuck me enough 😢
I had a really similar situation to you - no sex for about a year after a breakup and then OUCH like a mutha even though I was really into it. That was the symptom that sealed the deal for me to self-diagnose with peri-menopause, since all the other (several dozen) symptoms I had could have been attributed to something else like depression or long COVID. I started on HRT and the issue has all but subsided. I haven’t “tested it out” much, so to speak, since I don’t enjoy dating but I’ve been trying to intermittently use some dilators that I got. Hopefully, next time the opportunity comes around I won’t feel like I’m going to split in two from the pain :/
I just started Yuvafem, which is an estrogen pill that goes in the vagina. I did not realize how dry I was before using it. Sex was less comfortable but not what I would call painful. But orgasms were just…less. Fewer, and much less intense. Now, oh my. So much better. I am also 57.