43 Comments

Vaginal atrophy is not fundamentally caused by lack of use. It is a primary symptom of estrogen deficiency ....women who are on hormone replacement therapies have intact vaginal tissue. Intercourse while the tissue is rough can hurt and actually make it worse.

There are many estrogen rich vaginal creams OR...HRT...hormone replacement therapy?

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Yes, I have a history of breast cancer and cannot use estrogen creams. Leaving the other as the only good options.

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My sister, who has had breast cancer, was okayed by her oncologist to take vaginal estrogen to treat painful sex, one of the aspects of GUSM (Genitourinary symptoms of menopause) which his throat more accurate and less demeaning term preferred now instead of “vaginal atrophy” which, as you point out, makes it seems like the woman’s failure. I am also on vaginal estrogen, and no pain! Not even a little bit, which I was experiencing before. Check with your oncologist you may be surprised to find you are a candidate.

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I think he already rejected the idea, but I will bring it up again at my next visit. Thank you for the encouragement to keep searching.

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Although on the whole I really enjoyed this piece

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Not “his throat” -- “is the”

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Glad you mentioned that, Corinne because I was about to go all hey hey hey on these comments. 😂

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Each woman’s situation and health constraints need to be assessed, not one size fits all…..

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Agreed!

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Yes. It is an estrogen problem. I’m in my late 70s and have been using an estrogen cream for 15 years. Very safe, no systemic exposure, and makes sex much more comfortable and enjoyable.

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Thank you. I am afraid the advice at the end of this piece is misleading?

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I've been told both, by my doctor. That it's waning estrogen, but also, usage. Was prescribed kegels and...other activities. :)

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She must have discussed estrogen creams too?

Google “ dyspareunia”, the medical term for painful intercourse.

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My guess is your doc observed both mucosal atrophy and muscular laxity. Kegels are specific for the latter, estrogenic supplementation for the former…..irl, few women stay with Kegels to get much out of it……

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Maybe just a bit misleading. I’m no doctor, but I don’t think an active sex life will prevent vaginal atrophy.

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"To slow or prevent the process of thinning and shrinking of the vaginal tissue, your doctor may suggest performing “Kegel” exercises on a regular basis. Kegel exercises involve the tightening and loosening of the pelvic floor muscles as if you are stopping and starting urine flow.

An increase in sexual activity has been found to increase the blood flow to the vaginal wall and therefore strengthen and tones the muscles surrounding that area." https://walnuthillobgyn.com/blog/atrophic-vaginitis/#:~:text=To%20slow%20or%20prevent%20the,stopping%20and%20starting%20urine%20flow.

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Makes sense. Kegels are a bit tedious. Given the option, I’d rather have sex. 😏

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"An increase in sexual activity has been found to increase the blood flow to the vaginal wall and therefore strengthen and tones the muscles surrounding that area."

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Kegels can of course improve muscle tone. If people are willing to make that commitment…

Vaginal atrophy refers to the vaginal “mucosa” or tissue…highly responsive to endogenous and exogenous estrogens. Different parts of the structure.

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I am sure that plays a role…..but…get the estrogen cream ladies….so you can enjoy the activity.

Was an Ass’t. Prof. In Dept. Ob-Gyn at U. of Wash. Schl. of Med., Seattle, Wn and sex therapist (PhD) for over 30 years.

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More articles like this please!

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Great article, thanks so much.

I have suffered with UTI’s all my life and have always been embarrassed by this, I think because it used to be called ‘honeymooning syndrome’ and had implications of promiscuity.

I haven’t had an attack for a while but still have periods of urgency, especially in the refrigerated section of the supermarket! My doctor prescribed a bladder relaxant (solifenacin) well as low dose estrogen and it’s made a huge difference.

Just passing this on as it has really improved my life and made me less worried about being caught short.

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I love the raw honesty in this, how the narrator admits to her many self-doubts that we can all relate to but rarely cop to, and the humor with which she confronts what could be appalling news. Thanks for the advice to “work it, baby, work it”—a great lift-off from the many groundings of womanly aging.

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Excellent piece! I mean the writing! I enjoyed it very much!

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I love this story as you know! So glad it's here! Yay!

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I tend to soak calendula flowers in olive oil as a post-bath anti-itch skin treatment. The olive oil, mixed about 1/3 to 2/3 with coconut oil makes a very good, nontoxic, moisturizing lube for late in life sexual encounters. I just keep a discreet stash in an old Kiehls jar on the back of my toilet. Also good for things like aggressive TP, or any other situation in which one's lady parts need a little love.

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Good to know! Thank you.

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Plain coconut oil works just as well!

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Thank you for a really great post!

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This resonated with me! Last year I visited a new gynecologist and after getting home I was notified of a message on the doc’s portal. It was a new diagnosis. You guessed it. Instead of talking to me about it, HE just typed it in and I was introduced to my atrophying vagina. I had no idea. Yikes. I’ll be seeing someone else next time.

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Finding a doctor you have a good relationship with is so important. Thank god my gynecologist in New York could double as a stand up comedian.

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OMG, just left my doc with a UTI. My pee looked ok to me, doc said it was bloody. Sheesh! Perfect timing here and great writing. I’m trying Amoxicillin, will keep you posted.

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I laughed out loud and woke my husband! As a woman who consistently gets U.T.I.'s, I laughed at the image I formed of the medical staff debating your prognosis. Thank you for educating me on why my doctor asked me, "What color is your pee?". What I heard when she asked was, "What color is pee?" I laughed and said, "Yellow. Why?"

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Your voice shines through here. So real and so you!!

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Thank you for such an honest & laugh out loud piece. Great writing!!!

I got a UTI once on vacation. Horrible timing as we had prepaid tours scheduled each day. I was at a loss as to what caused mine since I had never had any in my life until age 45 & then had 2 in 6 months. The amazing PA at a tiny clinic in a rural town in Arizona asked me if I used lubricant for sex & what kind because she suspected it was the culprit. She was right! Now I only use water based lubricant & replace frequently. She said some bottles of gel based "warming" lubes & other with additives are breeding grounds for bacteria. Who knew?

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:D Love it.

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Excellent writing! Raw and humorous. Thank you for sharing.

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