You say you’re twelve years past menopause (a full year without menstruating). In menopause the changes to the vulva and vagina are significant, and they are what we call “chronic and progressive,” meaning they get worse over time. The condition is called genitourinary syndrome of menopause (GSM), with impact to the vulva, vagina, and lower urinary tract. This can lead to painful intercourse, the vulvar irritation you describe, and, for some women recurrent bladder infections and urinary frequency and urgency.
If infections and vulvar skin conditions have been ruled out, it’s likely you’re seeing symptoms of GSM, and the only really effective solution may be “re-estrogenizing” the vagina. Rest assured, vaginal application of estrogen has no impact outside of the genitals (we actually use this in our breast cancer patients). It is absolutely safe to use, for all women; there are virtually no contraindications for use of localized estrogen.
I’ve also had some success with women using Epigyn Calming Cream in situations like this. Unfortunately, due to packaging reengineering, the product may not be available until mid-summer. Rosebud Woman also makes a couple of products that may be helpful: Honor Everyday Balm or Soothe Calming Cream.
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.