Vagifem will have some influence on tissues within four to six weeks; I hope it won't be long before you note some benefit.
Beyond tissue health and lubrication, having comfortable sex depends on vaginal "capacity." I've recommended vaginal dilators to a number of women who've found them helpful; dilators are smooth cylinders of graduated sizes used to gradually, gently stretch the vaginal opening and depth.
If it really is just dryness (did I say "just dryness"?) making intercourse painful, the Vagifem and a good lubricant should get you back on track. And, of course, remembering to take the time you need for arousal!
Dr. Barb DePree, M.D., has been a gynecologist and women’s health provider for almost 30 years and a menopause care specialist for the past ten.