I’m 53, and I had a hysterectomy in my early 40s. I shouldn’t be surprised that I’m in menopause.
But here I am. My skin and hair are dry. I sleep poorly. I have night sweats. I forget things. And I have vulvovaginal atrophy (VVA).
I shouldn’t be here, I think. “Use it or lose it” should have prevented this! I DO use it. My blog isn’t going to research itself, after all.
VVA is the thinning, drying, and inflammation of the vulva and vagina (and often the clitoris as well). It can lead to vaginal tearing (leading to pain and infection), discomfort or pain with sex, loss of elasticity in the vagina, urinary problems, difficulty with sexual response, and more. You can learn more here (easier to understand for most of us) and here (more medical language style).
Because VVA results from a decrease in estrogen levels, estrogen is the most common way to treat it. System-wide estrogen replacement (pills or a patch that increase the estrogen level throughout the entire body) can help with some VVA. Or, local estrogen might be prescribed (estrogen tablets, creams, or a ring to increase estrogen in only the vulvar-vaginal tissue.)
However, estrogen replacement isn’t a good idea for everyone. (Talk with a medical provider about what is best for you and your own medical condition.) What can you do if you are concerned about using any hormones or if your doctor recommends against even local estrogen treatment? Or what if you use estrogen replacement and it isn’t as effective as you would like?
Does it mean that you are stuck with the demise of your vulvovaginal tissue?
Fortunately, there are some non-hormonal treatments that can help us.
Help without Hormones
I’ve done a bit of research on this. Some of this information came from a conversation with the nurse practitioner (NP) who is treating me. I also spent time at the HysterSisters, Mayo Clinic, WebMD, and the U.S. National Library of Medicine websites, as well as looking at research articles related to the ideas presented here.
I encourage you to read Help for Vaginal Dryness at Bonny’s OysterBed7. My friend Bonny not only talks about how DHEA (a supplement) can help with a variety of VVA symptoms, she also explains the biology of dryness.
MEDICAL DISCLAIMER: Talk with your own doctor about whether these treatments can work for you. This blog post does not constitute medical advice, but it can give you some ideas of what to ask about when you talk with your own doctor.
The information below includes affiliate links.
1. Check Your Medication
Although low estrogen is usually the cause of VVA, symptoms can be aggravated by some prescription medications. Talk with your doctor about your own medications. If any might be contributing to your symptoms, discuss alternatives. Discuss over-the-counter medications as well. Antihistamines and cold and allergy medications not only dry out your sinus tissue, they can also dry out your vaginal tissue. As someone with chronic sinusitis, I was not pleased to learn this—but it is better to know than not to know. A nasal spray or sinus rinse might be better options for you.
2. Use Artificial Lubricants
Don’t have sex without a lube. Just don’t. You may find that an initial burst of your body’s natural lubrication doesn’t last. Always have something quickly accessible.
Most drug stores carry a variety of artificial lubricants to use during intercourse. Avoid products that say they add warming or tingling, as it can irritate dry vaginal tissue. Otherwise, try a variety of products until you find something that works well for you.
Check out your grocery store, too. Many couples enjoy coconut oil or olive oil. If you are using condoms or sex toys made out of rubber or plastic, oil can lead to a breakdown of the material. If you are not using condoms or if you use only silicone toys, oil can be a great solution to a lubrication problem.
3. Moisturize, Moisturize, and Soothe!
Although vaginal dryness isn’t the only problem that comes with VVA, it certainly is a major one—and it isn’t a problem only during sex. Constant dryness can lead to itching and general discomfort as well as contribute to urinary problems.
Vaginal moisturizers can help by hydrating and soothing the vaginal tissue.
- Replens attaches to your dry vaginal cells to provide moisture until they are regenerated (every three to five days). Using it three times a week helps vaginal tissue become more hydrated and renewed. Several clinical studies have shown an improvement in vaginal moisture.
- HyaloGyn doesn’t appear to have as much research support behind it, but I’ve seen it recommended on several medical sites as a good option. HyaloGyn should be applied three times a week.
- Some women find it helpful to apply olive oil or insert a Vitamin E suppository that will be absorbed by your body overnight.
Healthier tissue can not only make sex more comfortable, it can help with sexual responsiveness and orgasm as well. What’s not to love?
Sometimes we need immediate relief. Vaginal moisturizer may not work right away, and if your vulva is what needs some soothing, vaginal moisturizer isn’t going to do much.
My NP said that she often recommends Herballove’s VRD Formula II and Creme Complete by Perrin Naturals. I have not been able to find out enough about either of these products to be able to tell you how they are applied, or whether they even can be applied internally. If you find yourself in need of something to help soothe inflammation related to VVA, talk with your doctor about whether these products might help—and be sure to ask how to use them.
4. Rejuvenate Your Vagina
The most effective way to treat VVA is through vaginal rejuvenation.
Vaginal Renewal™ is an approach recommended by A Woman’s Touch Sexuality Resource Center in Madison, WI.
The Vaginal Renewal™ program promotes blood flow to the vulvar skin and to the vagina through 1) external vulva massage and moisturizing, and 2) internal massage with a vibrating wand. They recommend the FeMani® Vibrating Massage Wand Dilator Kit. If that is a bit pricey for you, a standard vibrator may work well. Click here for detailed instructions.
You’re Going to Do What to My Vagina?
I’d like to describe two other treatments that are effective in restoring vaginal lubrication and elasticity, improving urinary incontinence, and restoring sexual function.
The Mona Lisa procedure is an internal laser treatment that helps plump up tissue. The laser treatment essentially creates some cellular damage in the vagina in a way that forces new growth–and the new growth is healthy tissue. Mona Lisa apparently has great success rate, but insurance doesn’t cover it. Most places in the country will charge $1800-$3000 for it.
ThermiVa works by heating the vaginal tissues to prompt the formation of new collagen and nerves in the vaginal tissues, using radiofrequency energy. ThermiVa also can be used externally on the vulva to treat vulvar atrophy. ThermiVa costs from $2500-$3500 and is also not covered by insurance.
Studies show that both of these procedures are effective, although they do need to be repeated yearly. If you’d like to learn a bit more, check out these resources:
- ThermiVa vs. MonaLisa Touch, Integrity Medical Aesthetics
- Can a Laser Improve your Sex Life? Harper’s Bazaar
- Vaginal Lasers: What’s Happening in The Field, Women’s Wellness Institute of Dallas
I just want to know: who volunteers to be among the first women to test these treatments? Whoever these women are, I am grateful that they have helped us have new options to reclaim our sexual health.
Your Medical Provider
The most important thing you can do in addressing your VVA is to find good medical care.
As comfortable as you may be with your regular gynecologist, you might be better off with a vulvar specialist or someone who is a member of the National Vulvodynia Association. Ask your gynecologist for a recommendation.
These websites have good resources and have information that will help you find a provider:
- National Vulvodynia Association
- International Society for the Study of Women’s Sexual Health
- North American Menopause Society
You may also find these sites helpful, depending on your location.
- Berman Sexual Health (Chicago)
- Women’s Wellness Institute of Dallas
- The Centers for Vulvovaginal Disorders (Washington, DC, New York, and Santa Fe)
God designed women to enjoy sexual intimacy. Fortunately, we have options that can help us do so comfortably.
Even to your old age and gray hairs I am he, I am he who will sustain you.
I have made you and I will carry you; I will sustain you and I will rescue you. Isaiah 46:4
Previous posts about my journey to reclaim my sexual health during menopause
Image credit | Oldiefan at Pixabay.com