Let’s talk about Vaginal Atrophy

drminkin“I am always happy to talk about happy vaginas,” Dr. Mary Jane Minkin told us as we started our interview about the subject of vaginal atrophy. When you get a quote as good as that, you lead the story with it!

Dr. Minkin is clinical professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine and has a private practice in obstetrics. We wanted her to teach us a thing or two about VA, which affects “well over 50 percent of post menopausal women,” but is an issue which few women talk about, she explained.


First things first: What is Vaginal Atrophy?
VA is a treatable chronic condition that affects the vagina and the surrounding tissues during and after menopause due to declining levels of estrogen. Symptoms include vaginal dryness, pain and bleeding during intercourse, itching in and around the vagina, vaginal soreness, urinary tract infections and painful urination.

Why have I never heard of VA?
We are a purely puritanical society and sometimes people look at me funny when I talk about vaginas. But VA as an aspect of menopause is extremely important. Although the prevalence of VA is high, only 25 percent of sufferers seek medical help. Many women aren’t even aware that it’s a treatable condition.

I am going to teach you about a terrible term in gynecology that relates to all this. The Pudendal Nerve is one of the main nerves in the pelvis and one of the most important nerves in the body. It innervates the vaginal and clitoral areas, which, in laymen terms, means it supplies nerves to those areas. Interestingly, the Latin meeting of the word pudenda is that of which you should be ashamed.

Besides feeling ashamed, women are not taught enough about their own bodies. Menopause knowledge hasn’t been promoted very much because we’re a society that values 22, not 52 year olds, and menopause is a result of aging.

But the FOF Generation is changing that, isn’t it?
It is, but slowly. We need to talk about menopause. The average age at menopause in 1900 was 48 and the average female life expectancy was 48. We’re leading longer lives, well beyond past our menopausal age, and we’re going to get dry vaginas. We want to lead good lives, not just longer lives.

Viagra was introduced in 1998, but no one bothered to talk about the men’s partners.

Is VA treatable?
Yes, three modalities of estrogen treatment make vaginas moister and more comfortable and come in the form of creams, tablets and rings. They all work to reverse the atrophic changes in the vagina, as far as the FDA patients and doctors are concerned.

vaginaAre there downsides to these treatments?
They’re all well tolerated. All are quite safe, and there are no adverse side effects.

What is the difference between taking an estrogen pill and estrogen delivered via the tablet, cream or a ring?
The estrogen a woman takes systemically, in the form of a pill, delivers estrogen to her blood stream and it definitely reaches her vagina and is delivered to her vaginal tissue. Estrogen taken this way also eliminates hot flashes.

If estrogen is placed directly into the vagina, it will treat VA but it won’t take care of hot flashes or other menopausal symptoms because it doesn’t reach the blood stream. Hot flashes, however, tend to be prevalent around menopause and then improve over the course of time, whereas vaginal symptoms can get worse over time.

Which treatment do women prefer?
Different women prefer different treatments. I try to tailor the method I recommend to the woman, based on her preferences.

The Ring: Some women don’t want to think about their vaginas and like the ring. They insert it, it stays put for three months and then they change it. Others can’t stand something foreign in their body or their partners can’t stand the way it feels. Some women fail to change the ring or renew their prescriptions after three months.

The Cream: Some women like the feel of a cream; others hate the mess of a cream, or the need to wash the applicator. Many women who’ve had vaginal infections often associate the cream with the way they felt about Monistat. They don’t like the leaking.

The Tablet: I was the lead author of a study of 79 post-menopausal women currently taking vaginal tablets, who were previously treated with cream (85 percent), the ring (9 percent), or both (6 percent). We found that the majority of former cream users (66 percent) was “much more likely” to use the tablet.


Published in the International Journal of Women’s Health, our study showed that for 52 percent of all respondents, the switch to tablets was recommended by the patient’s healthcare professional. Slightly less than 20 percent of patients themselves requested to change treatments and 15 percent specifically wanted to use tablets. “These insights show us that patient preferences should be ascertained and help guide the type of treatment we recommend.

What is the difference between lubricants and estrogen therapies?
Many women find a lubricant, such as K-Y or Astroglide, helps at the time they’re having sex. But these products don’t have long-lasting effects; they just make intercourse easier.

The estrogen treatments we’ve been discussing are all considered moisturizers, which provide ongoing moisture to the vagina, not just at the time of intercourse.
Estrogen increases pelvic blood flow and the nice tissues that line the vagina, which make nice plump cells.

If a woman hasn’t had sex in years, can she use estrogen therapies?
Absolutely. Vaginal therapies will reverse her symptoms. And even if you haven’t had sex in years, you still might have a new relationship at some point and will want to benefit from ongoing moisturizing.

Also, some women will end up with urinary tract infections if they let their vaginas stay dry for too long, since the bladder and vagina sit right next to each other.
The cells lining the vagina are basically the same cells that line the urethra and the bladder. When the vagina is dry, I know the bladder is dry. This leaves a woman more prey to being infected.

When the vaginal tissues become drier and thin out, because of lack of estrogen, then the good guy bacteria don’t like to live there anymore and you end up with a nastier crowd of bacteria, which can cause vaginitis and more urinary tract infections.

Does intercourse, without treatment, make VA worse or not?
It makes it better. The more sexual activity you have, the more pelvic blood flow you’ll have.

*Photo source: http://www.wikipaintings.org/en/georgia-o-keeffe/flower-of-life-ii

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  • suziq

    Read and learn. Do not expect your GYN to tell you everything or to be clairvoyant!

  • susannunes

    More about the FDA and criticism on so-called “vaginal rejuvenation”: https://www.cnn.com/2018/07/30/health/fda-vaginal-rejuvenation-devices-warning-bn/index.html

  • GloriAni

    OH! I’d like to add, I use a dose of (Emerita) progesterone cream a few minutes before the E3 Hydration cubes … E3 should not be used Unapposed … that is by using the LOW dosage and WITH progesterone cream, and very low dosage in terms of days used … I have had the BEST success and I believe, the best prevention.

  • GloriAni

    Hi all … I see this discussion (re V.A.) is from long ago … but just want to add two very important things I found. The second one (Bezweken suppositories) are what I am currently using with GREAT success. I add Vit. D3 (1,000 to 2,000 mg) and many other things for breast and uterine and overall health and prevention but love the SLOW and LOW dosage of what I’m doing … I did do a saturation week or two but am now down to only once or twice a week at VERY low dosages.

    So here are the two things I’d like to add: (please forgive me if somewhere in this thread these have already been mentioned.

    1. re Vagifem (Big Pharma) and more … and the less expensive and health justice way to get the same bioidentical via a compounding pharmacy.:


    2. Bezweken;
    please scroll down to HYDRATION CUBES … and please note they come in 1x and 2x dosages. Read carefully as there are some that also contain DHEA which you may want to avoid.


  • Patricia Daneman Amster

    Vagifem IS Esteogen, and a bad estrogen. Do research.

  • Patricia Daneman Amster

    Mona Lisa Touch Laser. Ck it out.

    • Kitten Caboodle

      Nice if u have a spare $5,000 or so:) & needs to be repeated for maintenance. nsurance does not cover.

      • susannunes

        It is also potentially dangerous to women:

        It’s just another form of FGM.

        • rjnvpn

          FGM – really? You’ve fallen off the edge lady.

        • suziq

          Are you crazy—it treats the lining–there is no mutiliation, no bleeding, no real pain. And I wouldn’t believe anything I read in the NYTimes!

      • rjnvpn

        Intimacy is worth it!

      • suziq

        Insurance in Europe doesn’t pay for this either but there are many more Gynos and specialists who use it. I had both atrophy and incontinence and the laser treatments were the only thing that helped both serious problems! I did all the research myself and paid for it all out of my poor retirement. I started with treatments every 6 weeks. All problems reduced more with each treatment and now I only go twice a year. No mess no fuss and I have my own personal glass insert that I bring to treatments! Don’t wait for insurance to pay or FDA approval just go for it.

  • Patricia Daneman Amster

    Ck out the Mona Lisa Laser Touch. It is helping me a Lot.

  • Patricia Daneman Amster

    Mona Lisa Laser Touch

    • susannunes

      Dangerous treatment that has been criticized by the FDA.

  • Patricia Daneman Amster

    Good luck. It is all dangerous, in my opinion, and it is all estrogen.

  • Patricia Daneman Amster

    Plus it can cause cancer and way more. Not only vaginal and more cancer, it can cause breast cancer

  • Patricia Daneman Amster

    This is NOT OKfor every woman, and Not safe for Every woman. Do Not say these topical hormones are. I used these topical hormones for a short while, and they absorbed, and caused Definate Problems, and they Do Absorb! People who have family who have had cancer, or if they have had cancer, should NOT USE THESE.

  • Hashmi Mart

    A good vaginal cream is a soothing and safe option to tighten the vagina and keep it healthy. Vagina tightening is one of the best natural solutions to cure diseases of the vagina and tone its layers which reduce the looseness and issues.

  • LJT

    are these VA treatments safe for women who’ve had breast cancer?

    • Patricia Daneman Amster

      Not hormones. NO

  • Gnu_Freedom

    It’s presumptuous to refer to all those with vaginal atrophy as “sufferers”. Clitoral stimulation is for most of us where orgasms come from and what we enjoy most. More often the “sufferers” are our husbands, but there are so many other ways to enjoy sexual intimacy.

    • Patricia Daneman Amster

      Agree, yet u still need to deal with ur vaginal atrophy and ur labial atrophy etc.

  • BuckeyeatHeart

    I too suffer from Vaginismus. I have tried to explain the pain to my husband for years. FINALLY he understands and we are working on restoring our relationship. Hoping Vagifem will help in the process. My Dr could barely do a pelvic exam.

  • BuckeyeatHeart

    Research Vaginismus. It is very treatable with the right partner. Good Luck

  • Karine

    Oops. Forgot to mention that the online Canadian pharmacy where you can order Gynatrof is at http://www.well.ca

    • Patricia Daneman Amster


  • Karine

    I found a non-hormonal vaginal gel that is available in Canada. It is really outstanding. It is called Gynatrof. I started using Gynatrof for vaginal dryness that I had been experiencing since my mid-40’s. Within the first week there was a noticeable difference and my symptoms improved substantially with continued use. I wish I had found the benefits of Gynatrof years ago. I had tried Replens but found it too be more expensive on a monthly basis and definitely a lot more messy. Gynatrof application is easy and certainly mess free. The gel is very thick and does not leak out. This product has changed my life. Before using Gynatrof, sex was very painful for me and my husband suffered as well because he still enjoys that part of life. Since using Gynatrof, we are back to our happy healthy pain free sex life. Regrettably, the product is not yet available in the USA, but you can order it from an online Canadian pharmacy that will ship to the USA. It comes out to approximately $36 Canadian or approximately $27 in US Dollars for a 50 ml which will last approximately 3 months.

  • kristine08

    Someone I use to work with described the exact same thing to me. She just closed up shop and that was that!

    • Patricia Daneman Amster


  • kristine08

    I have been using ESTRACE cream along with Mimvey for hot flashes. It still hurts having sex. Its like I am having sex with Edward Scissorhands!
    I have tears and stinging and burning pain. I cannot wait for it to end. I am sure I feel different to my husband as well.
    This is the worst thing to happen to woman, Its true that we end up dried up like a prune. I no longer feel sexy even though I am at my lowest weight ever. That Ostephena medication is very expensive and it has some terrible potential side effects, (Black Box label)
    Funny VIAGRA is covered for men, but not anything to help woman.

    • Patricia Daneman Amster

      Dont use this. It is a hormone, and it is dangerous, and risky

      • susannunes

        And of course you are big on dangerous laser surgery, which has been roundly criticized by the FDA. You have no credibility.

    • Patricia Daneman Amster

      If this is the way it is for you dont do it. You need help, And you know it. Why havent u gotten help.why on earth would Anyone have a pleasurable experience be a Painful experience?? Why do this?

  • please don’t use hormonal creams. I have clients getting amazing results with sex and boudoir butters. http://bit.ly/1RRajPR

    • Patricia Daneman Amster

      Shut up about ur stupid butters. Take ur sales elsewhere

  • have you looked into using a jade egg to begin to work the muscles. just google it and then use a safe lube with it, something like Boudoir Butter or Sex Butter

    • kristine08

      Its like using organic coconut oil really. I can buy a giant jar for less than $20.00.

  • Rojas Ivelise

    OK my friend asked me but i ont no so this ?she havent had sex in 8 years first time she bleed and the guy thought it was y perid she havent had in 5 years

  • Nikki Potter

    Has anyone looked into the Mona Lisa laser therapy?

    • Patricia Daneman Amster

      Yes, i am having it now! It is amazing. Hormones are VERY dangerous. Topical hormones included.

    • susannunes

      Dangerous. It is another form of FGM, as far as I am concerned.

  • Jada

    As far as libido….I hear you. I use transdermal compounde Bi-Est….it’s a balance of prog/ estriol ( the safest estrogen) tailored to my hormone levels…I take a saliva hormone test every six months to maintain my safe optimum level for application. Now in saying this…yes this helps for sure with the libido but now I have to look into getting the door open and strengthening the walls! I do use vaginal estriol cream weekly that works as a lubricant but doesn’t seem to be doing anything for thinning…..I will look into Vagifem for sure.
    BTW…few if any GYN’s go with saliva testing largely because the were only trained for what is mainstream. Speak with a compound pharmacist … Ask questions it’s free…that’s what they are there for….then decide for yourself if you want to get a saliva test kit. I get my kit from the comp pharm….take the saliva test at home…mail in test…two weeks later the Compound pharmacist goes over the test with his recommendation and faxes the results with his recommended RX and my GYN calls in the prescription. Saliva hormone testing is more s curate than just testing blood.
    Hope some of this helps you and others in need. And thank you for sharing.

  • Jada

    What condition was your vagina in before you started with Vagifem? I’m about the same age as you. But I have thinning and narrowing….10 years without intercourse.
    I’m going to research Vagifem safety….

  • Judy

    I alsoI had breast cancer & was given Vagifem by my Ob. Because it is inserted vaginally the oncologist agreed to its use. It is only systemic estrogen that can cause recurrences. Also, please remember that anything with Soy taken oraly is similar to taking estrogen as they are similar in molecular structure!

    • but why would you want to chance using any estrogen. Why not use a simple organic solution and yes stay away from soy. check into Boudoir or Sex Butter http://bit.ly/1l71Luf

      • Patricia Daneman Amster

        Agreed. That is Insane

        • Patricia Daneman Amster

          Bonnie, the butter u are obsessed about and trying to sell everyone is not a solution

    • Patricia Daneman Amster

      Why dont u all know about the Mona Lisa Touch Laser?

      • susannunes

        Why do you troll?

  • Ani Animasola

    I am nearing 63. I had a complete hysterectomy at 41 and began Estrace tablets 28 days later. I was on the tablets for about 20 years. No problems. I started going to another physician who specializes in the Menopausal gynecology only. My estrogen was changed to Estragel 1 pump each thigh ever day. It works perfectly. I know I am lucky. However, my DH stopped being intimate almost 7 years ago. He would get no help for what seems to be ED. This is not the life I planned. At all. I never had vaginal pain during intercourse. But at least my estrogen seems stable. When a man doesn’t get interested when you wear high heels stockings and a pretty corset…well, what can you do

    • cmj

      Nothing darning..just walk about feeling nice about yourself… if he doesn’t respond give him the paperwork to anti aging bio identity hormone my doctor has large number male patients. Test blood not saliva.

    • Patricia Daneman Amster

      U are a complete idiot in taking oral hormones after a complete hysterectomy. Good luck in your future. Change doctors i suggest.

    • Patricia Daneman Amster

      Why did u have a complete hysterectomy?

  • tammy

    I am 48 and had an anal cancer and was treated with radiation therapy through my hips. The radiation caused my privates to shrink in size and makes it unable to have sex. I would like to know if there is any type of surgery that would help so my husband and I can have sex again it has been 14 years.

  • kristine08

    I use it twice a week. IT WORKS!

    • Patricia Daneman Amster

      Bad news. Twice a week..good luck..

  • GG SanDiego

    We can thank all the studies that said there was a slightly .0001% increased risk of breast and uterine cancer from using hormone replacement therapy for all the atrophied vaginas. Fortunately, I have had great, understanding doctors. After a complete hysterectomy at 30, I’ve been on HRT for 37 years. Sex is GREAT, skin looks fabulous, and I am the happiest person I know.

    • Patricia Daneman Amster

      U ar in Such denial….

      • rjnvpn

        You are such a “know-it-all”!

  • mary

    Does anyone have solutions they have discovered for their diagnosed condition of Lichen Sclerosus, I have found few MDs specializing in treatment of the vulva who,for advanced LS cases, have surgical procedures they can do….but insurance coverage is spotty to say the least, for this condition, because the surgery is considered experimental in the US…health services in England and Italy have approved surgery for this…but not the US……..also there is the problem of finding a treating surgeon if you do not live in Southern California… where there is a surgeon specializing in surgery of the vulva,who is having good results with his surgical procedure and is part of a research project working for government approval for this specialized surgery …..I live in KY and have medicare plus a “carve-out supplement” from my pre-retirement university employer…. I am not in a position to pay thousands upon thousands of dollars for this surgery….although I had a confirmed, by biopsy diagnosis more than 15 years ago, and have been ‘unpenetrateable’ vaginally for that long, even after prescription treatment that my treating MD (the Director of a major university’s OB-GYN Department) said was successful. I have yet to find someone in the medical field who can respond as if this is an impairment to my health….my experience with this condition is that a healthy sexual relationship with a man is not possible and it is tremendously frustrating and unsuccessful…….I am diving into my annual tradition of research and hunting my medical system for help right now….I look forward to a solution to my LS…….using my curiosity at least, if not always my hope and faith that something helpful will happen.

    • Bo

      I also suffer from LS which causes labial scarring and vaginal atrophy.
      If surgery were performed would the adhesions not return? Is there a list anywhere of doctors who specialize in treatment of this issue? Can you give me the name of prescription your doctor recommended? There is almost nothing on the internet to help with this problem and I was so grateful for your post. Thanks for any help you can give me.

      • Patricia Daneman Amster

        Yes. Mona Lisa Touch Laser. It fixes it. Most people are way too cheap to spend the money on themselves for their Pleasure to invest in the Mona Lisa Touch Laser, for their External and internal Vaginal issues. This laser works. Takes 3 sessions..6 wks apart, then 1 x a year. I am a patient.. i am not anything more than that,

    • Patricia Daneman Amster

      Yes. Mona Lisa Touch Laser

  • Janet Gerl

    Can you please talk about Bioidentical hormones from plants. NOT synthetic hormones from mares urine (pregnant horse urine).

    • cmj

      I have been taking bio. 2010 had a hyst. I started with anti aging dr. tested my blood not my salvia. Cream is a compound made of natural products yam, sweet potatoes, gives me no hot flashes, regrowth hair down that area. My libdo tingle and interest in sex is back . I also take vagifem tiny tab to help mosit and keep vagina open. Now I want to tell you…I didn’t wait for my husband with no sex drive to come to me I used a thin rubber lubed fake I purchased to open myself up. He hadn’t wanted intercourse for long time so. I figured it was going to close. Yes I did bleed, I stopped cleaned up did it again few days later until that fake long reached my backwall and I was opened up. Opened up carefully gently then when he comes to me once a month I am able to enjoy my 59 year old sexual experience in comfort and keep that measurement and vagina open without use it will close up.

      • Lin G., New England

        You’re such a hot ticket! Love it!

        • cmj

          I wish…but shes still open.

        • Patricia Daneman Amster

          Then do it, and take your chances.

      • Jada

        Thank you for sharing….this is encouraging. I stated trying to (open the doors) with the sized dilators but the some bleeding due to thinning. I will try waiting as you did for a few days….I think I need to try this Vagifem everyone seems to be using.

        • cmj

          Yes vagifem really opens and keeps it open.

          • Patricia Daneman Amster

            Vagifem is as dangerous as any hormone.

          • susannunes

            So is laser surgery. Get a clue.

      • Patricia Daneman Amster

        They are still hormones, and u can still bet cancer from bio identical hormones, in fact my friend did.

      • susannunes

        Your vagina does not “close up.” The walls touch naturally. Some people need to take a class in human biology.

    • Patricia Daneman Amster

      They are still hormones to your body!

  • kathleen

    I’ve been on 0.5 activela for years great!

  • Precisely.

    My nurse-practitioner recommended ‘Wild Oat Extract’ taken orally as a way to stimulate libido gently plus to moisturize the whole region — vaginal as well as adjoining organs and membranes. This set of comments just reminded me of that recco.

  • Precisely.

    Way back in the good old feminist 1970s there was a book called “Our Bodies, Our Selves” which became a series of books; each successively discussing women’s needs as they grew older. In those books, I recall reading about douching with a mild apple cider and water solution, inserting yogurt overnight to readjust the bacterial habitat back to a healthy environment, and also using Slippery Elm Throat Lozenges as a vaginal suppository to cleanse and rebalance the vagina. Having used all 3, separately, numerous times over the years, for problems other than odor, I can absolutely state that one side-effect is a positive shift in ‘smells’. But if you haven’t seen a gyn or nurse-practitioner (or a group such as Planned Parenthood) recently, I wonder if you might consider it, since sometimes strong odors are indicative of an imbalance or infection.

  • whisper

    I think it is disgusting how women are constantly enslaved by the medical profession for our achieving every aspect of sexual health. While, men generally only need to access the internet for this or that sex aid and help. When are women going to be liberated from their money hungry docs to find for themselves the best affordable ways on their own? What of lower income women who can’t afford to seek a self serving doc for her sexual health? Is she doomed to suffer a life of sexual pain because she can not afford a greedy docs prescription? Why not make all aids for sexual health and birth control available over counter for women as readily as they are made for men? We shouldn’t need a greedy docs signature to solve VA issues every freaking three months of the rest of our lives.

    • Bullseye

      It’s not the doctors. It’s big pharma.

      • Patricia Daneman Amster

        U all have lost it

    • cball

      This whole lack of easy access to helpful products and scripts forces men to look at younger women who do not have these issues. I am very frustrated by the doctors who really only want to work with women “of childbearing age” and the overpriced/no insurance taken ones who do specialize in HRT etc.

      • kristine08

        thank you. I agree 100%.

        • Patricia Daneman Amster

          U too

      • Patricia Daneman Amster

        U need a mental health check up.

    • Lin G., New England

      I hear you! I totally agree too! Sometimes I wonder if some women are partnering with women (in part perhaps) because they’re more empathetic with the issues and won’t give up trying to find help. [Just-a-thought.]

    • Patricia Daneman Amster

      U are unrealistic. Anti establishment. Greedy. And full of crap. Get a grip. Doctors are great. U are an arrogant pos.

    • rjnvpn

      Planned Parenthood should be doing this, don’t you think?

  • Maliene Brannon

    I am now 76 years of age and took an HRT (Premarin tablets) from the time I was 31 until two years ago, due to having had radiation and cobalt treatments for cancer. The radiation destroyed my ovaries, sending me into early menopause. I would like to begin taking something to combat the changes I am experiencing due to the lack of HRT. What do you recommend?

  • Babyblue

    I’m 57 and haven’t had sex for about 7-8 years. I wished I could find the right help for myself. It started off as pain after hitting menopause. It does make you feel like you aren’t female any more. I believe in living as clean as possible with organic everything. I am a big advocate of bio identical hormones. I use a vaginal gel that is inserted three nights a week and a biest cream that I use twice a day 6 days a week. I just recently saw my obgyn and she said my vaginal tract is narrowing now with lack of use. Now what do I do?

    • Jada

      Oh goodness same here…..I use estriol bioidentical vaginal cream and Biest transdermal cream on back of knees. Narrowing makes it very difficult to even think about getting a pap. I just started tryin sized dilators. Not ready to give up but getting close.

    • cmj

      You need to use it you. Treated as if you were doing a beauty treatment glide super lube, thin and medium dildos metal slide in rubber more human .

  • kristine08

    I am so glad I am not the only one.
    What else is there to add?
    Its like our life as a woman is over.
    My husband is 13 years older than I, and still very frisky.
    IT HURTS for hours after we have sex.
    I feel as thin as a balloon “in there”.
    No wonder men go out an cheat.
    My OBGYN acts annoyed with me, when what she prescribes, does not work.
    Estrace & momvey, and only my hot flashes went away.
    Suffering with a fake smile~

  • kristine08

    I have read all of this a million times. I was prescribed Mimvy, and then, she added the Estrace cream. Sex is so painful and for hours after, I throb with pain. Its not working.
    2002, I found out I had Hashimotos thyroiditis. The OBGYN, I had at the time (male) preformed a “failed balloon oblation”, (for heavy periods-symptom of Hashi) and when that “failed”, he sent me to a specialist.
    This “specialist”, gave me (3) shots of LUPRON, (3) weeks apart to prepare me for “zag laser” surgery. They could not do it, because my uterus was overly shrunken, the sides were all stuck together. I brought them an article called “MEDICAL MISHAPS”. All about hypothyroidism. “Specialist”, sent me for the bloodwork, and my thyroid was super low. Even my primary care doctor missed this.
    So, I have all that, in addition to menopause.
    I have the worst doctors.
    I guess there is nothing else to do. Suffer with a smile~

  • My wife, Tamara also use coconut oil for her yoni. Ever since she has been great. Try check it out at http://coconutoilaslube.com

  • Hashmi Mart


    Nice Post

    Woman has a many delicate body part and it may become loose on account of childbirth. There are herbal vaginal cream gives you complete youthfulness and brings back the vagina into its original shape.

  • Dioso

    Vaginal Atrophy: Unbelievable as it sounds, our doctors do not know of all beneficial products and therapies out there. There are other options out there for lubricants which nourish and last. I began doing my own research and found out about some wonderful products, which I (being without active sex partner) combine with glass dilators to avoid vaginal atrophy. Why on earth are the drugs the first thing a GYN grabs for? Well quite simply, any good GYN is in demand, has a heavy schedule, and may not be aware of the differences of a lubricant that is for sex, vs long lasting.

    I’ve also been guided, by Drs, to lubes which have glycerin and other infection prompting ingredients.

    I’ve found sliquid H2O to be a better quick (not lasting beyond sex/insertion) lube when I didn’t yet have longterm needs. Now that I am older I am reviewing NeuEve and YesYesYes, with NeuEve possibly working better longterm as you don’t have to apply it often… and it’s noted to have multiple benefits for vaginal aging issues. I will report back here when I have finished my review of those and other items.

    The message here is don’t settle for A,B,or C, when there is also D, E, F &G showing lovely results.

    As for the dilators when combined with these lubricants, you can reverse and prevent vaginal atrophy.

    Also if your partner has stepped back due to ED issues, beware of what that lack of sexual activity can do to your vagina over time… Atrophy began to rear it’s head after the two years my husband avoided sex due to ED. Use a dilator, if you do not have a partner to penetrate you. Start out with a narrow one (I use glass high quality) and work your way up to a more normal size.

    • Judy

      If you were nearby I’d Kiss you! Thank you sooooooo very much for your wisdom. We could be sisters from another mister lol! I’m 60 as of March 28th and have been celibate since 1997. Menopause was complete by 54 years old. I came across sliquid H2O because I wanted organic only. Afraid to use it. I’ve been taking organic green tea baths and I seem to be ok. You however, spoke of the glass dilators which I had no knowledge of. May Jehovah bless you for sharing your wisdom online. I humbly thank you and wish you were my personal friend as I suspect you are humble and kind as well as wise. Thank you so much again for the life saving relief. Humble and Sincere Thanks, Judy.

      • Patricia Daneman Amster

        Oh dear jehovah….?

    • kristine08

      Coconut oil is good to try.

    • cmj

      Well said that is what I have done.

    • Jada

      Thank you for sharing….I find that organic coconut oil is a great lubricant with zero additives. Even the safest ones out there still contain additives…didn’t want to risk anymore problems. Coconut oil is an anti-fungal and loaded with antioxidants….I now use it “all over my body…head to toe” Fantastic moisturizer for feet….and weekly scalp treatment as well. And works with dilators very well. BTW….your story is very similar to mine.

    • Diann

      Where do you get the glass dilator

    • Patricia Daneman Amster

      Read my post above, and see what u can do to absorb a bit

  • JohannaBrocker

    for me even though I have an extremely competent doctor any pelvic or Breast health exam was extremely difficult

  • JohannaBrocker

    I have that problem I do physical therapy with a specially trained therapist who treats vaginal problems I was referred by my doctor I still have a dry vagina but I cannot tolerate estrogen cream I get headaches when I use it plus I’ve had cancer so I’m limited in my choices

    • Jada

      I have the same problem as Nadine P. How and what does a physical therapist do that treats vaginal problems? What more can she do than what Gyn usually recommend getting the dilator expander set. That kills with thin vaginal walls and a narrowed vagina from going without sex for ten years…GYN exam is not possible…it’s all so depressing. I use compounded estrio vaginal cream but that doesn’t seem to do nothing but lubricate. It’s the safest estrogen of the three types. I’m 64…so I guess there is no hope for me…..
      Any suggestions from you or any blogger is more than appreciated.

      • cmj

        The more gently use of area brings blood flow to it.This helps with entry of everything to area…

      • Kathy Hutchinson

        I dont know if you are going to read this, but there is a treatment out there, called The Mona Lisa Touch. It is a laser treatment that restores moisture and thickness to the vaginal wall, and is particularly effective post menopause or post hysterectomy, especially for women that do not tolerate HRT well. I have read over 500 reviews for the procedure and they all give it five stars. I am planning on having it done post hysterectomy. At the current time, it is not covered by insurance, but is expected to be covered within the next few years. Hope this helps. Look it up. The Mona Lisa Touch.

        • Jada

          Kathy…..Thank you for the information. I will check it out. Insurance coverage or not….I will find a way. All I have to do now is find a doctor within reasonable location to me. Since my initial postings…I Have continued with the compounded Estriol vaginal cream twice weekly (Estriol is the weekest of the three estrogens and used vaginally does not get absorbed into the blood stream) My new RX is compounded with Estriol, Vit E and Hyaluronic acid. Although it is expensive (not covered by insurance) the good thing is it’s bioidentical and there are no chemical additives The compound pharmacist was very helpful….he recommended adding hyaluronic acid because it works like Estradiol without the risk. Doctors have no knowledge of how to prescribe compounde meds…so the Compounded Pharamacist makes the recommendations to the doctor. BTW….aside from that….I do use transdermal compounded Bi-est…..Estriol/Progesterone….six days on one day off. The RX for this was based on Saliva hormone testing which I do every four months…this important do…to make sure there is a balance and not a dominance of one to the other. And of course not covered by insurance! Thank you again….I will do a google search right now on the Mona Losa Touch.

        • Patricia Daneman Amster

          Agreed! I just started it. The hormone cream absorbed in my body, and it is horrible. Cannot believe people think it is nothing. It is Dangerous!

      • If you dont’ want surgery and want an organic products free of hormones and other awful products look at Boudoir Butter http://bit.ly/1RRajPR I’ve seen women have great results

        • GWDash

          Do you profit from sales of that product? Your multiple comments seem spammy. 🙁

          • Patricia Daneman Amster


        • Patricia Daneman Amster

          It doesnt solve the problem

    • Johanna, have you ever tried using Boudoir Butter? http://bit.ly/1RRajPR I’ve seen women have great results

      • Patricia Daneman Amster

        Bonnie. Take ur sales pitch somewhere else

  • Trina Bruno

    anyone tried Ostaderm V for dryness after menopause? What dose do you use each day? I had some burning after 10 days –

  • you can try this http://bestlubezone.net/

  • good post..i like this blog. i founded a Best lube you can try this

  • Absolutely written content material , appreciate it for selective information.

  • marylou

    I take Tamoxifen. What are my treatment choices?

  • Susan

    Thank you -it is nice to know I will be able to help people with this –

  • Jeanette Wagner

    I’m 52 went through menapose when I was in my early 40s I haven’t had sex in at least 10 years I started dating again and the thought of having sex actually felt normal again but the opportunity presented itself penetration was not possible lubricant didn’t help either I was so embarrassed this man was so patient and understanding but it was like there was a wall that would not let anything through. Could really use some advice. Is there something wrong with me now that I’m 52 or what?

    • Shelly s

      Hi Jeanette,
      I went through menopause at age 29…and I am now 43. You sound just like me, except I am married. The last time my husband and I had intercourse was over a year ago. It was so painful that I cried, which is so incredibly humiliating. Like you said, it’s like there is a brick wall. I feel hopeless, and quite frankly, I’ve become very insecure…fearing he will look elsewhere to satisfy his needs. Anyway, I began taking osphena about 4 months ago. It is supposed to help vaginal atrophy, but it is without hormones. Now it’s just a matter of seeing whether or not it is working, but it’s a mental thing…I’m afraid to even try. When I do, I will let you know if it is helping. I feel your pain 🙁

      • Debbie

        Are pap smears painful as well?

        • Sylvia

          Yes, for me the pap smear really stung! It also causes bleeding due to the thin tissues. Vagifem should help with that.

      • Machell

        I think the problem that you may be having is called vaginismus. This is when the muscles in the vagina spasm involuntarily. It essentially “closes” the vagina. Look it up and read about it. I thought my problem only came from dryness, but I realized it was something more. I really hope this helps someone. For me, I was just happy knowing that it wasn’t just me.

    • Susan

      OMG ! the problem I can’t seem to find anything on- the only thing I have seen are therapeutic cones you use and if you are athletic that will tighten-

      • Maria Camacho`

        You mentioned something about tightening. I’m researching and reading up on HRT and wondering if it will help firm and tighten my vaginal walls.

  • Olga


    I’m married and I do have sex. Haven’t had any surgeries. I’m having issues with it hurting when I have sex, sometimes spot bleeding and the odor. I can’t tolerate the odor. I have tried the over the counter washes and sprays but that just seems to cover the odor. Can you recommend anything for all of this? Is there a solution?


  • Rose Mills

    I’m 54 I haven’t had sex sense my hysterectomy 5 years ago. Can you tell me what I should use. Thank you.

  • Nadine P.

    does Dr. Jane Minkin have an web site to go to ask questions and get answers to questions about vaginas?

  • Nadine P.

    I have not had sex for a long time due to shrinkage of the vagina. I’m not talking about just the moisture loss, but the actual size of the opening has gotten smaller. Now we can not have sex because his penis is too large to go in. Yes, sex has been painful in the past, had blood due to rubbing during intercourse.

  • Viginal atrophy is seen due to the dryness of the vagina and to avoid it the use of the lubrication product is much necessary.

  • Judy Nutting

    I was using Estrace and caused irritation to all my lady parts. Do you have any suggestions for a more gental product? I see my doctor in a couple weeks.


    • sophie

      I have been on Vagifem for almost 5 years. It used to be 25 milligrams here in the USA, and then they lowered it to 10 milligrams. While on 25 Mg. I inserted the tablet twice a week, but when they lowered the dose, I take 3 ten mg. tablets per week.

      It works like a charm for sexual intercourse. But you must be diligent in taking them. If you skip them or forget, your vaginal lining will let you know. It is like the birth control pill, skip it and you could be in for a rude awakening.

      Also, it takes a good ten days to get your vaginal lining in shape, so you’ll be inserting one a day for ten days, then you are good to go, and depending on your age, and dryness you many only need two tablets a week. I am at an age now (67) where I need 3 a week. Thank God for Vagifem!!!!!!!!!!

  • All is good until I got breast cancer and had to quit using estrogen. So how do I take care of the soreness? Oncologists gave me permission today to use a small amount of premarin cream to get rid of the irritation but not all the time. I need a solution. I can’t live with this irritation. Had to quit my oral premarin also. Everything was fine until I had to quit this treatment. I need a solution to make me human again.

  • kcolor273

    I am post menopausal, and have been experiencing problems with intercourse for a couple of years now. I have tried Estrace cream along with Vagifem pills–this seems to help the dryness, but it doesn’t help the pain during intercourse. I also tried the ring–also doesn’t help the pain. I did have the ring with a higher dose of estrogen and that helped a lot, but the doctor wouldn’t let me stay on it for more than a year. I’m afraid to take oral estrogen, and my doctor hasn’t suggested it either. At this point, I don’t have much hope. At least it’s comforting to know that I’m not the only one with these problems–when I was growing up, I always thought it was only a man who had problems with intercourse when becoming older–no one ever talked about a woman’s problems relating to sex as she aged.

  • Debbie T.

    Hey Girls, I have been on and off of bio-identical hormone creams for over 10 years. The progesterone cream was difficult to rub into the skin because it was so thick. I used estrogen cream also which contained a small amount of testosterone (yes, women also have a small amount of testosterone, which declines with age along with the other hormones. Testosterone along with estrogen and progesterone, can give you back your sex drive. It also helps with energy and helps burn fat (men have more muscle than women due to testosterone). Anyway, a couple of years ago, I started seeing a doctor which prescribed hormone troches. I like these much better than the creams. You can only get these from compounding pharmacies. The troche is a small square you put between your upper cheek and gum, and it gets absorbed directly into your bloodstream. Ask your pharmacy if they can make it using a beeswax base instead of polyethylene glycol, which is a chemical that has many side effects (look them up on WebMD).

    Another thing I wanted to mention to women who are afraid to take estrogen for fear of getting cancer. Your doctor should prescribe progesterone along with the estrogen, which helps prevent what is referred to as estrogen dominance (which can cause cancer). Hope this info. helps.

  • i never knew any of this. Thanks!

  • Good to know!

  • Ali Moss

    Thanks Geri, I’ll check out Vagifem.

    • jeny

      I am 62 yrs and tried Vagifem for a week and the side affects were awful.. i had the effects of dimensia..omg . I stopped it immediately.My
      body rejects prescribed meds and searching for Natural products? Anybody recommend something.. have not had sexual relations in 5 years and now have a partner.

      • Jane

        I have a low thyroid which hormonal creams make worse, so I use coconut oil instead, it is semi solid at room temp so you make it up into small pellets using a tea spoon and freeze them. Then you can insert one each evening. Vit e capsules inserted, or broken open and applied can also help but I have not tried that yet. I also use a lubricant called Yes, available in UK, not sure about US, which is all all natural product.

  • Jenilee Thiederman

    So afraid to try estrogen therapy, with a cancer risk.

  • I’m 57 and I don’t want to hurt…

  • Geri

    Hi Ali,

    I know Dr. Minkin recommends Vagifem tablets, by Novo Nordisk.


  • Linda M

    I am 68 and have been on estrogen pills since I was 33 (Estradiol and/or Estrace pills for the last 20 some years). I’ve had no problems at all and my body is liquid, vagina quite lubricated and I can’t imagine life without it. Hysterectomy at age 32 allowed me to go this route without any worry on my part.

  • Ali Moss

    I was diagnosed with vaginal atrophy and prescribed Estrace cream which I took for 2 years. It worked very well but I stopped because it does have alot of side effects and even the manufacturer says only to use the lowest dose possible and only for as long as needed. I have yet to find a product that doesn’t have side effects. The Luvena product sounds interesting but if used every 3 days as recommended, it is way too expensive for me as insurance does not cover it. I am curious as to which products the doctor recommends that do NOT have side effects, especially in the tablet form.

  • Catherine

    great article…thanks Geri

  • Donna

    I had Uterine cancer 3 1/2 years ago. I am 59 and desperately needed some help for dryness and painful intercourse. My friend was suggesting bio identical hormones because she feels wonderful on them. My doctor said no to that but said I could use vagifem which is inserted into the vagina. This does help a lot. I still wish I could use the bio identical to get the libido back. I don’t really know what the difference is.

  • I am post menopausal and have had all kinds of problems the doctor is talking about including interstitial cystitis, AKA Painful Bladder Syndrome (which I’ve nicknamed PBS). I have always been very negative about taking hormones because of its association with increased cancer risk. My ob-gyn recently prescribed a probiotic cream called Luvena which seems to help. Are there any other suggestions besides estrogen?