Vaginal Dryness and The Big M: The Painful Truth

When I was a young girl, vaginas were not a topic for polite conversation. Or any kind of conversation, save in the odd sex education class.

Times have changed. And with the advent of Menopause, so have we. The Big M is not polite, and we need to confront one of its more disturbing manifestations head-on. Namely, vaginal dryness.

It isn’t vaginal dryness that we notice right off the bat. It’s the first time we have sex and it HURTS. A normal, healthy sex life is something most of us have taken for granted for many years. Suddenly, physical intimacy becomes pain. Who saw that coming?

Loss of libido occurs and that is distressing enough. Yet, when desire returns and we find that sex is painful, it can be a devastating experience. I’ve received soooooooo many letters about this phenomenon. As one of the single goddesses wrote after a disastrous encounter, “It was one of the most humiliating experiences of my life.”

Because our normal lubrication has “dried up” with the hormonal changes of aging, we may need help. Thankfully, we have options these days.

Our best course of action is to supplement with a good lubricant. Use before intercourse and keep it handy in case you need a little more during. Emerita makes one of my favorites called “Natural Lubricant”, a water-based, non-greasy lubricant. It feels very similar to our own natural lubrication. Hence the name.

Emerita also makes a product called “OH! Warming Lubricant” which can help fuel the “fire down below” in a gentle, sensual way while providing “natural” lubrication. The Venuses like this one a lot. Available at health food stores, major drug store chains and direct from Emerita.com.

Another of my favorites is called “Wet Naturals” which also feels like our own lubricant. Wet Naturals has three varieties. Beautifully Bare is most like natural. Sensual Strawberry is lightly flavored and scented, not sticky. Silky Smooth is a silicone based lubricant that is great for massages and also works underwater. (Hey, whatever floats your boat.....) Available at major US drugstore chains and >Drugstore.com.

Another option is topical estrogen applied vaginally. This is a form of HRT (Hormone Replacement Therapy) and requires a prescription from a physician. Topical estrogen is more effective than either patch or pill for vaginal dryness.

The Mayo Clinic discusses several forms on their website The Mayo Clinic:

1. Vaginal estrogen cream (Estrace, Premarin, others). You insert this cream directly into your vagina with an applicator, usually at bedtime. Your doctor will let you know how much cream to use and how often to insert it, usually a daily regimen for the first few weeks and then two or three times a week thereafter.

2. Vaginal estrogen ring (Estring). A soft, flexible ring is inserted into the upper part of the vagina by you or your doctor. The ring releases a consistent dose of estrogen while in place and needs to be replaced about every three months.

3. Vaginal estrogen tablet (Vagifem). You use a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet, for instance daily for the first two weeks and then twice a week thereafter.

While vaginal dryness may initially freak us out, it doesn’t have to signal the end of our sexual vitality or enjoyment of physical intimacy. As with so many manifestations of the Big M, we learn workarounds and find our way to a new “normal”.

And hey, all you goddesses out there, we’re open to recommendations for other products or remedies. After all, women sharing their wisdom is how we will all survive (and ultimately thrive) on this midlife journey.