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?

I use estriol cream and it’s been brilliant. I got it prescribed from an online pharmacist and had stopped itching and needing to run to the loo (after a few bouts of urine infections). Worth a try whilst you are waiting for your GP appointment.

Is there a reason that you aren't on HRT? I found that utrogestan and everel patches sorted out all this for me

Thanks again for all the comments & suggestions.

I had initially thought of posting this on the sex forum, but it seems to be inhabited by sleazy blokes mostly, and I wouldn’t have got nearly so much sensible advice.

I’ve already got Yes VM but have ordered the oil-based one & it arrives from Amazon today. And I’ll speak to the pharmacist at the weekend about an oestrogen cream while I wait for my GP appointment.

Hello

Firstly, congratulations on finding a loving relationship after such a difficult time — that is really something positive. Many women notice that comfort, arousal and confidence can take time to return, especially after a long period without sex, even when using vaginal oestrogen.

From my own experience, I found that using a gentle water-based lubricant made a big difference with comfort, and I personally felt reassured following advice from menopause specialists like Dr Louise Newson who often talks about options such as YES. Taking things slowly, allowing plenty of foreplay and focusing on relaxation can also help, as sometimes the body needs time to feel safe and responsive again.

If discomfort continues, it might be worth reviewing symptoms with a GP or menopause specialist, as sometimes small adjustments or additional support are needed.

I have both vagifem and the Ovestin cream (on prescription) the inserts weren't enough, ask your doctor for a prescription.

I see you have a plan, OP. Just wanted to say that I found increasing the Vagifem to every other day and also using Ovestin cream externally helps a lot. The Vagifem on its own wasn't enough. You'll probably need a prescription for the Ovestin as it's topical oestrogen.

I know — I couldn’t find any actual estrogen added in the ingredients, BUT I have been suffering with dryness and itching in the crease of my leg/vulva area and vulva as well and this stuff has 100% eradicated it — possibly it’s the hyaluronic acid in it? Don’t know but in two years it is the only thing that has given true relief.

I’d go to the Dr and have them check for Vulval Lichen Sclerosus.

Obviously she can use it or not, likewise with your suggestion. She asked what others have found helped and would suggest — that is what helped me. Why on earth would I not share that?

Not quite. Vagifem is the brand name for vaginal pessaries containing 10mcg estradiol. Generics are called Vagirux, Estradiol 10mcg and Gina (the latter bought from pharmacies after going through health screening). In the US the generic is Yuvafem.

Estriol is a different type of estrogen used in 3 types of cream/gel, most commonly prescribed is Estriol 1mg (used to be called Ovestin) and in Imvaggis pessaries (weakest treatment)

Ahh okay, I was thinking of Estradiol. Thanks for the clarification.

Hey Op. There’s already a lot of really good advice on here about creams and hormones that can help, so definitely worth looking into those.

One other thing to bear in mind is the emotional side of things and your long period of abstinence/the troubles with your previous partner. Going a long time without sex can make things feel painful or uncomfortable at first, menopause or not. You probably have a few emotional blockages after your unhappy marriage adding to your physical symtoms.

It’s also worth remembering that for many women, the pelvic area is very responsive to stress and emotions. Things like anxiety or tension can affect muscle tightness and lubrication. So if you’re feeling relaxed and safe, your body is generally more likely to respond in a comfortable way.

It might help to take things super slowly and also spend some time on your own getting used to sensation again, so your body can finally feel safe to open up. That can make a big difference, and over time it should start to feel easier.

I use estriol vaginal cream. It's been an absolute life saver. The burning is incredible if you don't use it. I get it on repeat prescription and use it when needed. No after affects at all.
Speak to your GP. If you're 60 or over you will be eligible for free prescriptions

I use coconut oil. I prefer it to commercial lubricants.

I was single for about 10 years but I did a lot of “self care”. Maybe try a few toys on your own to get your mojo back. Once you’ve started the juices flowing as such you’ll be in a much better position to share this with your new partner.
ps I am no longer single but still do self care at least twice a week 👌

I'm on vagifem but find if I don't use it every night I have the same issue as you. GPs recommended dose of 2 a week just doesn't work, I've had to resort to buying it off the Internet.

I would recommend get an Estring, I found this a LOT better than Vagifem. I also use Ovestin externally every night and then I use Hydromol ointment each morning. I use Yes WM as a lubricant. This regime came about after a lot of trial and error!

I think my symptoms have worsened as menopause has gone on- with my previous parter (2-3 years ago) it wasn’t an issue at all, and then I had some time on my own (with plenty of self-care! 😉).

The yes OB arrived today & am finding it better than the VM, so thanks to all who recommended it.

This! Also with a new partner, after years (& years) in a sexless marriage. 61 years old!! Ovestin cream is what you need.

@BananaSkinShoes is your testosterone prescribed by your Gp? It has never been mentioned to me as an option only oestrogen and progesterone?

Agree an estriol cream should help externally with 'plumpness' and so, to a certain extent, moisture as well - hope your GP review in a month can adjust & in the meantime your OTC trials help out.

For arousal & climax, that's heavily testosterone driven, and you may find your GP is prepared to help with gel for that, or maybe not-many won't 😬

Another poster mentioned DHEA topically, which as they said is a precursor for both oestrogen and testosterone & has very good results for urogenital symptoms in menopause. It's also a generic (no patent), so it's very cheap & as a result, wildly under-researched as there's no money in it for the drug companies.

There have been some limited trials which have shown quite good success for libido, bone & muscle retention and urogenital symptoms at around 30mg a day orally rather than just as a local cream. Although I think it's not recommended if you have kidney issues or high cholesterol & it's recommended to keep an eye on cholesterol levels if using long term.

Your GP might not be prepared to prescribe DHEA due to the limited trials - it's frustrating no further research is being done when (because?) it's cheap as chips...like £20 for a year's supply. Goes to show how much the sector actually cares about women's health when there's no money to be made 😔

Keep on having fun OP, you've earned it!

Vagifem used to be manufactured in a higher 25mcg dose to be inserted x2 week. The evidence that it is safe to use this way still stands and would be the equivalent of x5 week of our current 10mcg dose.
I’ve attached a resource for healthcare professionals explaining this you could show to your GP.
You could also mention that Estring, another current approved treatment, contains the equivalent of approximately x5 Vagifem a week.
Some doctors believe that the dose is in topical treatments is higher than it actually is.
https://www.chelwest.nhs.uk/professionals/gp-hrt-advice-guidance

Editing to add - anyone considering increasing the dose should discuss first with their doctor and follow nice menopause guidelines which includes that three months should be given to see if the prescribed treatment works before reviewing. Many doctors do not inform us that using treatment is not a quick fix and it takes time to improve the tissue.