Women's Health

pain with sex

Vaginal Atrophy and Painful Sex: What You Need to Know

Vaginal atrophy is the thinning, inflammation, and drying of the vaginal walls associated with low estrogen levels in women.

Vaginal atrophy is most commonly experienced after menopause; however, it can also occur after hysterectomy, some gynecological cancer treatments (like vaginal stenosis), and in lesser degrees while breast feeding.

It's commonly associated with the distressing symptoms of painful intercourse and urinary incontinence. The good news is that there are several treatment options available to manage these symptoms

3 ways to address painful sex with vaginal atrophy:

1. Dilator Therapy

Vaginal dilators, also referred to as vaginal trainers, are used to restore the depth, width, and elasticity of the vaginal canal to allow for sexual activity, tampon use, or medical exams.

Vaginal atrophy treatment may include the use of dilators to progressively improve the mobility of the vaginal tissue while learning to relax the pelvic floor muscles. 

2. Use a Vulvar Balm

IR Balm

Vulvar balm for vaginal atrophy assists in providing moisturization to dry, irritated vulvar tissue. Vulvar balm can be likened to lip balm for dry, irritated lips.

During sex, personal lubricant should be used in generous amounts. Vaginal atrophy can lead to bleeding due to the thinning and dry nature of the vaginal canal.

Using 1-2 tablespoons of personal lubricant can help prevent painful friction during intercourse. A clean suspension dropper can be used to apply personal lubricant deeper into the vaginal canal.

3. Talk to your doctor about hormone or bio-identical hormone replacement

Some women can benefit from using vaginal estrogen cream to improve the health of the vaginal tissue.

Topical estrogen applied into the vagina two to three times per week can help improve blood flow to the tissue, making it more supple and thus decreasing the incidence of urinary incontinence and pain during sex.

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ByDr. Amanda Olson,DPT, PRPC