Sounds like you’ve been doing a number of the right things: You’ve been using dilators, a vibrator, lubricant, and vaginal moisturizer. It sounds like you’re at a point where localized estrogen, Osphena, or Intrarosa would be helpful for you to achieve your desired outcome.
Any of these prescription drugs will provide elasticity, a critical factor for getting the “stretch” needed with the dilators. Take your dilators in to your health care provider and have this conversation, too. He or she can help you determine whether you can get further capacity with the methods you’re using or whether, as I suspect, you need to take the next step and add a prescription to your routine to restore health to the vaginal tissues.
It’s hard to get to the final goal without that option--and that final goal is definitely one worth working for! Good luck.
While the cream you describe would be fine with the dilators themselves, we doctors recommend against using oils in the vagina. Oils tend to promote the growth of bacteria and break down or weaken tissues. Lubricants especially made for vaginal use are worth the investment.
Out of sight; out of mind. That’s how it is with the vagina. As long as it’s working and isn’t causing a fuss (which, granted, becomes more iffy at this stage of the game), we forget about it.
Nothing wrong with that.
But, ladies, your vagina is a marvelous thing, so in the interest of a little community ed on this underappreciated organ, here are some fun and quirky facts—maybe things you didn't know—about your vagina.
Okay, so you’ve tried everything. You regularly use a good, natural moisturizer, plus a lubricant during sex. No soaps, sprays, scents, dyes, or synthetic underwear ever touch your bottom. You’re the queen of vaginal hygiene. And still you’re troubled by dry, itching, or inflamed genitals and painful penetration.
Talk to your doctor about using a localized estrogen product for your vagina. These medicines deliver low dosages of estrogen right where it’s needed: the vagina and vulva. Not only is localized estrogen medication very effective at relieving the discomfort of vaginal inflammation or atrophy, but it also restores natural vaginal lubrication and elasticity. In fact, while it won’t relieve other menopausal symptoms—like hot flashes—low-dosage vaginal estrogen is sometimes more effective in relieving menopausal genital problems than systemic hormone replacement therapies (HRT). Moreover, the dosages are so low, the side effects and complications so negligible, it is often used by breast cancer survivors.
Vaginal estrogen comes in several forms: a cream (used twice a week), or slow-release tablets (used twice a week), or a ring (which needs to be replaced every three months). Don’t, however, confuse the Estring vaginal ring with Femring, which is the high-dosage HRT in a vaginal ring form. (Confusing? It can be.) Your doctor will tailor the amount and frequency of application for the maximum effect at the lowest possible dose. It may also take several weeks for treatment to become fully effective.
A few precautions:
As a medical doctor, I try to provide a place where uncomfortable or unfamiliar topics can be discussed in an open, honest way, without inhibitions or worries about “what people might think.” For lots of people, both men and women, self-stimulation or masturbation falls into that “uncomfortable” category. Some of the myths surrounding masturbation—like it causing blindness or hair to grow on the practitioner’s hands—have faded, thank heavens! But there’s still a lingering perception, I find, that self-stimulation is somehow less acceptable for women than for men.
For post-menopausal women, self-stimulation is especially helpful, whether or not they have partners. It can solve problems with vaginal dryness or tightness: Stimulation causes your clitoris to swell, helping to maintain healthy blood flow to the walls of the vagina, which in turn can help keep your vagina open, strong and responsive. (It’s the old “use or it lose it” rule.)
If vaginal dryness or tightness is a problem, self-stimulation can also be a way to temporarily feel sexually satiated if intercourse is too painful. I say “temporarily” because I don’t recommend that you think of it as the solution to painful intercourse. Always seek medical attention if you’re experiencing any kind of vaginal pain, because there are lots of remedies.
Another benefit of stimulating yourself is the way it helps you to get to know your own body and what satisfies you best. As hormone levels decrease and effect other changes in your body, what’s worked in the past may not be as satisfying now. It’s great to be able to experiment with your partner to find your new best experience, but that’s not always possible, for all kinds of complicated reasons. Old habits die hard, and either you or your partner may feel tense or intimidated about changing things up. You can experiment to see what works for you and then share that knowledge with your partner to make your sex lives more mutually satisfying.
If you don’t currently have a sex partner, self-stimulation is a great way to enjoy the side benefits of sex, like tension and stress release and the feeling of calm and relaxation that immediately follows a sexual session. Fantasy can be a fun part of it; picture yourself with a former lover—or George Clooney (or Dean Martin… or… you tell us!). And taking care of yourself in this way keeps open the possibilities in case you do find yourself in a relationship again. In my decades of practice, I’ve learned never to say never!
If your sex life is suffering from other issues—a rough time in your relationship or it seems to hard to get your love life back on the right track—I caution patients against replacing intimacy with a partner with self-stimulation. It may be the “easy” thing to do, but it can compound problems if you turn to self-stimulation instead of your partner for satisfaction.
Self-stimulation is a normal part of a healthy sex life. At this point in our lives, the last person we need to be shy with is ourselves. Who knows what we’ll learn?
In the last post, we talked about how pH levels affect the vagina. The second part of good vaginal health has to do with moisture. As we say at MiddlesexMD, moist tissues are strong tissues.
Normally, your vagina moisturizes and cleanses itself by secreting a clear fluid that seeps from blood vessels in the vaginal wall. When you become sexually aroused, blood flow increases, and so does the lubrication. Unfortunately, this process is regulated by estrogen, and we all know what’s been happening to that hormone lately.
With decreasing estrogen levels and circulation, vaginal tissue becomes thin and dry. Maybe you’ve noticed that you don’t lubricate as easily during sex so that penetration is difficult or painful, or maybe you’ve experienced vaginal dryness and discomfort at other times as well.
The good news is that this condition is easy to fix. You moisturize your skin regularly; you should do the same with the vagina. First, a little refresher on the difference between vaginal moisturizers and lubricants. Lubricants may be used in the vagina and on the penis or toys during intercourse to help with penetration and to make sex more pleasurable. Lubricants come in water- or silicone-based varieties or a hybrid of the two, and in various viscosities (thick to thin). Choice of lubricant is a highly personal preference and may depend on the activity you have in mind. Because it’s helpful to try different kinds, we’ve compiled a sampler kit of our favorites.
Lubricants last several hours, and the only rule of thumb related to vaginal health is that no oil-based product, including petroleum jelly, should be used in the vagina. They’re hard for the vagina to flush out; they tend to disrupt pH balance; and they also tend to deteriorate condoms. Lubricants can be used in addition to a moisturizer.
The sole purpose of vaginal moisturizers, on the other hand, is to keep vaginal tissue moist and healthy. Moisturizers last two or three days and should be used regularly, just like facial products. And just like anything you use on your body, you want your vaginal moisturizer to contain natural, high-quality ingredients. A few common ingredients in vaginal moisturizers (that are also present in lubricants) bear some examination:
When you think about it, the vagina is a pretty undemanding organ. It’s cooperated through childbirth and nights of passion; it’s soldiered on uncomplainingly throughout years of menses and the occasional “oops”—such as the patient of mine who applied Retin-A skin cream instead of Vagisil, or the friend who used Ben-Gay. Her vagina did a little complaining then, but soon returned to its cheerful self.
Because the vagina has rarely been the squeaky wheel, we’ve tended to tend to take it for granted. As we age, however, vaginal tissue thins, loses elasticity, and becomes dry, so, like other parts of our bodies, that wheel tends to squeak a little louder.
Often, vaginal troubles can be addressed—or avoided altogether—with some TLC. While few of us think about how to maintain optimal vaginal health, maybe it’s time to give that longsuffering organ some extra attention. The two major factors in maintaining a healthy, uncomplaining vagina are a good bacterial balance and moisture.
First, a science lesson: pH is a measure of how acidic or alkaline (basic) a substance is. The pH scale ranges from 0 (very acidic) to 14 (highly alkaline) with seven being neutral. A healthy vagina is slightly acidic, in the range of 4.5 to 5. This acidity is maintained by a delicate balance of organisms, notably the bacteria lactobacillus that produces lactic acid. This slightly acid environment helps to ward off infection.
When the pH level in our vagina is out of whack, unwanted bacteria and other organisms can flourish—Candida albicans, for example, which is the fungus causing yeast infections. Sometimes it doesn’t take much to upset the balance. A surgary diet, some kinds of soap, a round of antibiotics, or even one of those nights of passion can upset the flora in the vagina. Sperm, for example, is alkaline with a pH of 7 to 8, and so is blood with a pH of 7.4, which is why hygiene is especially important if you’re still menstruating.
Here are some suggestions for maintaining a good pH balance and for overall vaginal hygiene.