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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Vaginal Pain During Penetration Be Treated?

I am a 60 yr old woman. At the age of 58-59, I began having pain during intercourse upon penetration. It feels as if I have become too small to accept my partner. The pain is so bad that penetration is nearly impossible to bear. I do not self lubricate much anymore (or if I do at all it does not last) and try different types of lubricants, nothing seems to help.
Mon, 26 Oct 2015
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OBGYN,  's  Response
Dear madam,

At this age, after menopause, all the genital organs are undergoing atrophy. This is due to the deficiency of the hormone Oestrogen, which is a feature of menopause. Due to Oestrogen deficiency, the vagina also becomes atrophic and narrow. Even the vaginal lining also gets thinned out.

However, Oestrogen replacement has its own risks like vulnerability to the cancers of different organs. Hence, systemic hormone replacement is thought of with utmost care and investigations only. Instead local oestrogen cream (that too with thorough work up of the genital and breast tissues to the vagina) may help you. Oestrogen cream needs a regular application.

The other lubricants also do help during intercourse. Please do not use oil based lubricants since they are dangerous to the genital organs. You may use water based lubricants like vaginal jellies. Apply the lubricants at the time of insertion and not as a regular application, so there is no question of 'lubricant not lasting'. It should be applied to the penis as well as at the vaginal opening and inside.

I hope this solves your problem to some extent.
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How Can Vaginal Pain During Penetration Be Treated?

Dear madam, At this age, after menopause, all the genital organs are undergoing atrophy. This is due to the deficiency of the hormone Oestrogen, which is a feature of menopause. Due to Oestrogen deficiency, the vagina also becomes atrophic and narrow. Even the vaginal lining also gets thinned out. However, Oestrogen replacement has its own risks like vulnerability to the cancers of different organs. Hence, systemic hormone replacement is thought of with utmost care and investigations only. Instead local oestrogen cream (that too with thorough work up of the genital and breast tissues to the vagina) may help you. Oestrogen cream needs a regular application. The other lubricants also do help during intercourse. Please do not use oil based lubricants since they are dangerous to the genital organs. You may use water based lubricants like vaginal jellies. Apply the lubricants at the time of insertion and not as a regular application, so there is no question of lubricant not lasting . It should be applied to the penis as well as at the vaginal opening and inside. I hope this solves your problem to some extent.