My poor Vagina & Vulva!

[ChilledProsecco]

I’m 54, post-menopausal & not on HRT - except for vaginal (10mg Vagifem).

After many years in a sexless unhappy marriage, I have met someone wonderful, who is a loving & caring partner, but I am finding sex uncomfortable.

Things just feel very dry, irritated & sensitive down there. It takes ages to get physically aroused despite him being a very skilled lover, and I am finding it hard to reach orgasm.

Aside from using lubricant, is there anything anyone can suggest?

Is there a reason you can’t use lube? I also use vagifem and I AM on HRT but still suffer from dryness. I cannot express how much using lube has changed sex for me. If you are able to use it, I think you’d be mad to rule it out.

Sorry, I should have been clearer, yes we are using lube.

Vaginal oestrogen may help. If things feel tight, vaginal dilators can help, you can buy, they come in a set of various sizes, you start with the smallest with lube and gradually increase the size.

A big vote for vaginal oestrogen for starters - you can buy it as Gina over the counter and see if it helps.

Swap the pessaries for oestrogen cream. I really don’t know why they continue to prescribe the pessaries which are hard to dissolve to women who have issues with soreness and dryness. Ovestin or estriol cream is what you need, you can use it internally with the applicator and externally which will help plump everything up.

1. Up your vagifem to every second day or even daily until things start improving. It’s an extremely low dose.
2. Get this estrogen cream off Amazon for external dryness and itching (vulva). Finally,
3. Invest in one of those vaginal red light therapy wands. Yes they’re expensive, yes it works miraculously. I bought the joylux, there was a noticeable difference (including not having to run to the bathroom when I needed a wee) after only a week of use.

(Photo of estrogen cream being reviewed)

OP is already using vaginal estrogen.

OP, I’d see a gyne about this issue and ensure she examines you.
I am in a similar situation due to induced menopause post ER+ cancer treatment.

There is a hyaluronic acid gel that can be prescribed that you can apply daily to help moisturise in addition to the vaginal estrogen. It didn’t work for me, and we are on to a different path, but can’t hurt to see a consultant gyne.

Topical estrogen takes time to work in thickening and strengthening the tissue and restoring elasticity, should be given three months and then reviewed with your doctor. Moisturiser can also be used at other times, for example yes VM (or yes OB which is oil based and be kinder if the water-based VM stings). Yes OB is also a good lube, though not if using condoms.
If you’ve been using Vagifem for three+ months would suggest having a review with your doctor. You could discuss either increasing how often you use Vagifem or add in Estriol cream to use externally on the vulva or switch to estriol cream to use both internally and externally.
There are also other treatments available like Estring which is a vaginal silicon ring changed every 3 months delivering the equivalent of x5 Vagifem a week or Intrarosa, which is DHEA that the body converts to estrogen and testosterone. Options can depend on where you live and your area drug formulary.

A gynaecologist friend tells me all women in peri and post menopause should be using vaginal oestrogen and testosterone. He reckons it’s essential.

I use it every other day and I also apply testosterone a few times a week. I don’t want vaginal atrophy, genito urinary issues, a shrunken clitoris and a lack of orgasms and libido.

Another thing I have used and found helpful is Balance Activ moisture gel. You put it in at night a couple times a week or so. The only downside is it’s prone to leaking out, but overall is helpful. It’s like a moisturiser for your vaginal and hormone free.

Look up a company called Yes who make great lubricant and moisturiser

Have you tried an oil based lubricant? I found sex uncomfortable, painful at times, then I ditched our usual water based lubricant for the oil based one from Yes. It went on DH’s penis rather than on me and it was a game changer for us. Im not sure whether it can be used with condoms though.

Thanks for all the advice; I’ve made a GP appointment but couldn’t get one till 30th April so can try some of the suggestions in the meantime.

I’ve been on Vagifem for a few years now, but it sounds like I need something externally too so will try that oestrogen cream recommended from Amazon.

That “Estrogen” cream doesn’t actually contain any estrogen does it? Neither does their “Progesterone” cream contain progesterone.

I changed from Vagifem to Estriol (used internally and externally) and it made a huge difference. Vagifem never had the same effect.

The OP has said she uses Vagifem 10mg. That is vaginal oestrogen

What is with not reading the OP post? 🤷‍♀️ She said at the outset that she is already in vaginal oestrogen!

It’s exactly the same. Vagifem is a brand name. Estriol us the generic version.

Why would op use this when she can get proper oestrogen cream from the dr/over the counter at Boots?

It's not the same as one is a cream and one a pessary. IME the cream works better than the pessary as you can use it inside and out and the estring and cream work the best.

Also, its supposed to be used on your skin, not your vagina/vulva !!!

HRT and testosterone. Testosterone gave me my orgasms back. It took until I was on the maximum dose of oestrogen patch for my vaginal atrophy symptoms to go. I also use the pessary but it's the combination of all 3 that works for me.

Do you know if you can still use testosterone if only using topical HRT?

I second this, I can’t use hormones. I use the moisturiser most days and have the lubricant to use when needed!