What you describe is a natural result of the loss of natural estrogen through menopause. There are a number of localized estrogen options, including Estrace and Premarin creams, Vagifem tablets inserted in the vagina, and Estring, which is a ring also placed in the vagina.
The therapeutic dose of Estrace is 1 gram applied to the vagina and vulva two times a week; using less than that will be, as we doctors say, "subtherapeutic," which means it won't have sufficient effect! While the creams are effective when used as prescribed, many of my patients prefer and get more consistent doses from the ring or tablets.
You mention a family history of breast cancer. None of these options is "systemic," which means that they can be used by women with breast cancer risk factors--even by some breast cancer patients. There's a new option, too, that's non-estrogen: Osphena is an oral daily medication that showed "statistically significant improvement" in vaginal and vulvar pain.
It takes attention and consistency to regain comfort after being sexually inactive, but I'm sure you'll find it's worth the effort!
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.