At my last vaginal exam, the doctor could barely get her fingers inside and absolutely couldn’t insert the speculum. She said that I had vaginal atrophy. I’m in my late 50s and my doctor suggested hormone replacement therapy. I am interested in bio-identical hormones, but have been utterly unsuccessful in finding doctors who prescribe this and it doesn’t seem to be covered by insurance. What’s your suggestion for vaginal atrophy?
Before I get started, let’s note that I’m not a doctor. Furthermore, I’m doling out this advice from my 29-year-old ivory, self-moistening tower, where my vagina and I are sitting pretty, pretending that menopause will never happen to us, so I can only imagine your frustrations.
As I’ve already confessed to self-denial, the truth is time will eventually leave us all vaginally high-and-dry. Vaginal Atrophy (VA) causes chronic vaginal dryness, pain, and bleeding during intercourse, as well as vaginal itching and soreness during and after menopause due to declining levels of estrogen. VA affects 50-80 percent of post-menopausal folks.
The Bioidentical Hormone Replacement Therapy (BHRT) you mention, aka, “natural hormone therapy,” is one treatment option for VA which claims to use hormones that are identical to your body’s naturally occurring hormones rather than artificially constructed hormones to bring your body back to its pre-menopausal hormonal state, mainly by boosting estrogen — the hormone responsible for keeping your pussy in prime, plump-tissued, self-lubricating condition.
The risks of BHRT haven’t been thoroughly studied and are largely promoted by the non-medical community such as Oprah and Internet pharmaceutical companies notorious for making unfounded safety claims.
Speaking from my Ph.D.-less, pleasure-positive perspective, my first piece of advice is to vaginally hydrate with slippery stuff particularly suited for extra-arid areas. Commercial lubes like KY contain additives such as glycerin and parabens known for actually leaving tissues dry and sticky. Opt for ultra-moisturizing natural options such as Yes Oil-Based lube or coconut oil. Both add a thicker, longer-lasting lubrication to dry, sensitive tissues. Neither are compatible with latex condoms, dental dams, or gloves. Though lube reduces dryness during the action, it won’t solve all post-menopausal tissue issues, so speak with your doctor about longer-term solutions.
Also, you can jill-off! Masturbation is a great way to exercise the vagina. Not only do orgasm and pleasure increase tissue-boosting blood flow where you need it — and relieve stress from all those doctors visits — but it’s a great time to use dilating sex toys in the safety of your alone time where you can take it molasses-slow or throw in the towel when the fucking gets frustrating.
Take the medical route with the Berman Center Intimate Dilator Set ($30) which is an insertable vibrator with a set of sleeves that gradually increases the diameter of the toy so you can work up to more plentiful penetration. The vibration is great for relaxing tightened vaginal muscles and can assist in a clitoral climax, too.
The Dilator Set is made from hard, medicalized plastic so if you’ve got money to spend on a sexier, DIY path, get a few different sizes of ultra-slender non-vibrating dildos. Or, check out silicone vibrators such as the rechargeable Calla Vibe or Tango Vibe, both by Fun Factory, or the Ella or Isla by Lelo. These vibes are great for VA as they’re tapered in shape so you can work from slimmer to wider penetration at your own pace. Plus, they’re bonafide sex toy fun to use during partner play so VA can enhance rather than detract from your partnered sex life.
For readers that want to get ahead of the VA curve, kegel exerciser beads like Luna Beads are a great way to keep the vaginal walls toned and fit for their future foray into aging gracefully, vaginally. Otherwise, S.S., thank you for leading by example.•
Yana Tallon-Hicks is a pleasure positive sex educator and writer in the Valley. She has a website bursting with advice, workshops, and sexual health resources at yanatallonhicks.com.
