Menopause
PAIN WITH INTERCOURSE
Between 25 and 45 percent of postmenopausal women say they have pain during sex.
When sex hurts, you may avoid it, which could affect your relationship.
Why can pain with intercourse happen following menopause?
The urogenital diaphragm (the vagina, bladder, urethra, and pelvic floor) are densely populated with estrogen receptors. Estrogen keeps these organs healthy.
Estrogens maintains thickness to the layers of cells that line the vaginal wall. Specifically, the superficial layers which is rich in glycogen (sugar) that help to support healthy pH which in turn supports normal secretions and moisture.
Estrogen supports the natural folds in the vaginal wall called rugae which are rich in collagen, elastin and hyaluronic acid all of which give the vagina elasticity.
Women going through menopause decrease their production of estrogen, leading to less moisture production and thinner, dryer vaginal walls.
While other menopausal symptoms, such as hot flashes, typically decline over time, vaginal dryness tends to linger because it results from physical changes in the vagina — specifically atrophy of tissues, which become thinner, drier, and less flexible because of estrogen loss.
This leads to loss of the thick outer layer of cells, a loss in sugar which supports normal pH and moisture producing normal vaginal flora.
There is a loss of collagen and elastin in the lower layers which decrease the elasticity of the vagina.
Vulvovaginal Atrophy.
When the tissue inside your vagina thins, penetration can become painful. The pain can be sharp or burn. If the inside of the vagina thins enough, it can tear or bleed during sex.
Once painful sex happens, you may dread its return.
Anxiety reduces lubrication even more and may cause you to clench the muscles of your vagina during sex a condition called vaginismus. If sex becomes too painful, you may avoid it entirely.
Lubricants
Vaginal Lubricants reduce friction during sexual activity and can lessen pain or discomfort. A main reason to use these products is to make sex more comfortable, but they can also assist with arousal and pleasure. Lubricants are used when you need them — at the time of a sexual encounter.
Choosing and using Lubricants:
Lubricants can be water based, silicone based or oil based. We suggest glycerin-free and paraben-free options, while avoiding ones that are sticky. Some brands are Astroglide, K-Y jelly and Sliquid, and there are many others.
Many of the lubricants with additives that try to “stimulate or arouse,” can cause burning discomfort and should be avoided, especially if you are already dealing with vaginal discomfort.
However, these products do not change the underlying cause of your symptoms, particularly the cellular changes in the vaginal tissue. Estrogen therapy and other Food and Drug Administration-approved medications can get at the root cause of the problem much more effectively.
Contact one of our specialist at County Obstetrics & Gynecology if irritation and pain during sex don’t improve after 2 months of use, or if you have other symptoms.
Hormone Replacement Therapy
Hormone therapy steadies the levels of estrogen and progesterone in the body. It is a very effective treatment for hot flashes in women who are able to use it.
Treatments can be tailored to each individual woman depending on the nature and severity of your symptoms, age, and overall health.
For more information on the symptoms and treatment options call the office of County Obstetrics & Gynecology to schedule a consultation.
Vaginal Rejuvination
Hormone-Free Non Surgical Treatment
FEMILIFT
Femilift is a minimally-invasive technique that uses laser technology to revitalize atrophied genital tissue. The Femilift procedure can restore vaginal lubrication and elasticity and relieve discomfort experienced during sexual intercourse.
The Femilift procedure can alleviate these symptoms, including:
- Vaginal dryness
- Genital irritation, burning, or itching
- Painful intercourse
How does the Femilift work?
The specially designed laser handle directs a tiny carbon dioxide fractional laser at the vaginal walls, which stimulates collagen production. The tissue can then regenerate, growing healthier and more elastic, which improves vaginal lubrication and allows for a more comfortable and enjoyable sex life.
The course of treatment consists of three sessions, six weeks apart. The sessions take no longer than 5 minutes, and most patients experience no pain or discomfort. If you wish, your doctor can apply a local anesthetic cream before the procedure.
The risks of fractional CO2 Laser treatment are virtually nonexistent. Femilift is one of the safest medical procedures available.
Patients can return to their normal activities upon returning home from the procedure. However, you should avoid sexual intercourse for 48 hours. You may experience some redness or swelling for a day or two, but you shouldn’t expect severe pain or tenderness.
Most patients have been very happy with their results and have reported significantly less itching, burning, dryness, and pain during sex. Although the full treatment takes three sessions, you may start to see some improvement in your condition after the first session.