I'm postmenopausal and often have vaginal dryness, which makes intercourse painful. Is there anything I can do about it?

Answer From Shannon K. Laughlin-Tommaso, M.D.

Vaginal dryness can be a problem for many postmenopausal women. Vaginal dryness is a hallmark sign of the genitourinary syndrome of menopause, also known as atrophic vaginitis or vaginal atrophy. With this condition, vaginal tissues become thinner and more easily irritated — resulting from the natural decline in your body's estrogen levels during menopause.

To remedy vaginal dryness and painful intercourse (dyspareunia) associated with the genitourinary syndrome of menopause, your doctor might recommend:

  • Vaginal moisturizers (K-Y Liquibeads, Replens, others), applied every few days to moisturize and keep vaginal tissues healthy.
  • Vaginal lubricants (Astroglide, Jo, Sliquid, others), applied at the time of sexual activity to alleviate pain during intercourse.
  • A low-dose vaginal estrogen cream, tablet or ring, to reinvigorate vaginal tissues. Even if you're using systemic hormone therapy pills or patches, your doctor might recommend a low-dose vaginal estrogen treatment if vaginal dryness and related symptoms persist. If you've had breast cancer, talk with your doctor about the risks of vaginal estrogen therapy.
  • Ospemifene (Osphena), a selective estrogen receptor modulator (SERM) medication taken by mouth is used to treat painful intercourse associated with vaginal atrophy. This medication isn't recommended for women who have had breast cancer or who are at high risk of breast cancer.
  • Dehydroepiandrosterone (DHEA), in the form of a nightly vaginal suppository is a treatment that may ease painful intercourse in menopausal women.

Regular sexual activity or vaginal stimulation — with or without a partner — also helps maintain healthy vaginal tissues in women after menopause.

With

Shannon K. Laughlin-Tommaso, M.D.

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Dec. 07, 2022 See more Expert Answers