Sex Should Be Anything But Painful

Photo Credit: Ian MacKenzie, Flickr Creative Commons

Q: I am a 60-year-old female now, am postmenopausal, and have terribly painful sexual intercourse. I have been diagnosed with severe atrophy of the vaginal wall.  Is there anything I can do besides hormone therapy to help? I am a breast cancer survivor and have been advised against hormone therapy. Is there an over-the-counter product I can use? I have tried various lubricants without success.

Dr. Pepper Schwartz: Happily, there is quite a bit you can do. You can certainly use Replens, a vaginal moisturizer that has no estrogen in it and has been scientifically proven to plump up severely atrophied tissue. I would add to this a silicone lubricant like Pink or Eros that will make the vagina very slick. Replens has to be used several times before you see changes in the vaginal floor, but it should make a difference. Furthermore, there are additional products now in the final stages of Food and Drug Administration approval that also should help.

One last thought: Many doctors believe that estrogen cream is locally absorbed and that it is not dangerous to women who have had cancer. I have no opinion on this as I am not a medical doctor, but you might read the work of Dr. Susan Love, a feminist and cancer specialist who has strong opinions on hormones, not all of them kindly, but who does believe in topical use. It's a confusing area, so do some additional reading and consulting to see what the latest prevailing opinions are on vaginal atrophy.

In the meantime, do try Replens.

Dr. Schwartz  answers questions  every Monday, Wednesday and Friday.  Submit your question hereRead more of Pepper's  columns here . And be sure to follow Pepper on Twitter  @pepperschwartz.

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