I'm 62, stopped period at 55. I have terrible hot flashes but worst of all is having sex is terrible. What should I do?

we use lotion because of dryness but it tightens so he cant get it in.she has closed shop.when he does get in I'm in so much pain.what to do

Doctor Answers 10

Menopause

Hello
by describing symptoms it is going through the menopause period I recommend a hormonal evaluation of your estrogen to get estrogenic treatments also we can help with vaginal tightening and so you improve your sex.


Dominican Republic OB/GYN
4.5 out of 5 stars 2 reviews

Painful sex during menopause - laser treatments for vagiinal atrophy

One of the new non-surgical treatments for post menopausal vaginal dryness and atrophy is "Intima" by Syneron-Candela.  At our office we recommend three to four treatments which helps dryness, pain during sex and stress urinary incontinence.  These treatments cause little to no discomfort and minimal downtime.
As the hormone estrogen decreases in the body this affects the internal and external tissues of the body including the vagina.  Doing bio-identical hormones as an adjust to Intima may solve the problem.
Hope this helps.  Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 72 reviews

Bio-identical Hormones and ThermiVa

Thank you for your question.  Your symptoms are quite common and, luckily, treatable, but you will have to find a physician who is comfortable prescribing bioidentical hormone replacement therapy (BHRT) and who has a ThermiVa device (or two doctors).  Hormone replacement is controversial, however, and you will likely encounter resistance from many Ob-Gyns and primary care physicians, based on some reports of increased health risks with standard HRT.  In appropriately dosed and monitored patients, bioidentical HRT should maintain one's hormone levels as if she were a healthy, young adult (when cancer risk is naturaly at its lowest), using human-identical molecular hormones.  ThermiVa, unlike the laser divices Mona Lisa Touch and FemiLift, uses radiofrequency energy to gently and deeply warm the tissues without burning.  This results in treatment of 100% of the surface area of the tissue to a much deeper depth than any laser-based treatment could possibly achieve.  The end result is a totally rejuvenated vagina: improved moisture, better blood flow, growth of nerve tissue for heightened sensitivity, new collagen formation to improve urinary control and sexual comfort, and even correction of mild pelvic prolapse.  I have included two links to corresponding pages of our website as a starting point for you, but I encourage you to do some research and reading on your own, then find a physician or physicians in your area who is/are recommended and make the investment in your own happiness.

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Hot flashes and painful vaginal dryness are treatable by various means

Hot flashes respond well to hormone therapy. Either natural or synthetic hormones will do the job. If you're afraid, reluctant or unable to do hormone therapy, gabapentin works very well for many women and carries no cancer risk. Vaginal dryness and painful sex responds well to microdose vaginal estrogen therapy and/or laser vaginal resurfacing with FemiLift or MonaLisa.

Painful sex

Most likely you are suffering from lack of hormonal effects on your vagina which result is thinning in the walls of the vagina, also called atrophic vaginitis. You need hormones. Consult a physician who specializes in hormone therapy and get treatment. You'll be glad you did.An example would be hormone therapy, discussed in the link below.

Robert L. True, MD
Grapevine OB/GYN
4.9 out of 5 stars 7 reviews

Menopausal dryness and symptoms

There is a reluctance to begin women at or over 60 on hormone replacement therapy because of increased breast cancer, heart disease and stroke (different for those under 60) from Women's Health Study. However, you should talk to your OBGYN anyway--why be miserable--it definitely works. Vaginal estrogen ring/pill/cream can also work without the risk profile.Iperform MonaLisaTouch vaginal laser therapy in women such as yourself over the last year+ and it is very effective for people who will not be using estrogen. Consider then, finding someone such as myself who adds testosterone pellet injections every three months to eliminate safely many of your symptoms with now a DECREASE in Breast Cancer risk. This is a good alternative if you choose vaginal laser therapy in my opinion. Look at HTCA.

Terrible hot flashes and painful Sex

Braylon:Sorry to hear about your menopausal issues.  Thankfully, now a days women have lots of options for menopausal treatment.  Hormone replacement therapy might be a way to decrease the hot flashes you are experiencing.  This therapy comes in the form of creams, pills, gels and pellets so there is options to choose from depending on your situation.  A gynecology physician can discuss your particular options after carefully reviewing your health history. For vaginal atrophy, the newest therapy is the Mona Lisa Touch Laser. It helps build new collagen in the vaginal area making sexual intercourse more comfortable.  Don't give up, there is a lot that can be done to help you!In good health,Marc Winter

Marc Winter, MD
Laguna Hills OB/GYN

Sex life after menopause

Based on your question, it appears you suffer from vaginal atrophy, which occurs from the lack of estrogen. I've had many patients describe "it's like he's hitting a wall."  These type of comments indicate the severity of the dryness and pain one is experiencing. You probably would benefit from a combination of therapies to overcome the progressive atrophic vaginitis. I do recommend the MonaLisa Touch, internal and external treatment, to jump start the return of collagen and elastin to your vaginal tissues. This will allow the vagina to accommodate penetration.  Then I recommend pelvic floor physical therapy to overcome the contracted muscles at the opening and inside the vaginal canal. Estrogen therapy can be added to compound the positive effects of the treatment, especially during the pelvic floor therapy sessions. There is no one perfect modality for everyone so please see an innovative gynecologist to help you achieve the sexual satisfaction you deserve.

Consult your medical doctor for Hormone Replacement Therapy

Hello Braylon10,Thank you for posting your dilemma which is extremely common. You are postmenopausal and thus would benefit from HRT, not only for your vaginal health, but also for cardiac, bone and mental health. You need to visit your doctor for an examination to rule out other causes of pain with intercourse and for counseling. Yes, there are new lasers to help with vaginal dryness, but you should take care of your whole body as well.Best of luck,

Oscar A. Aguirre, MD
Denver Urogynecologist
5.0 out of 5 stars 23 reviews

Estrogen versus vaginal laser

I would start drug free and try to find a doctor with Thermiva or femilift. These are lasers that resurface the vaginal lining and improve dryness. You're having spasm or vaginismus from the discomfort which would hopefully resolve after a treatment or series of treatments. By refreshing the lining of the vagina you should be able to naturally produce more lubrication. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.