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Treating Vaginal Dryness

Q: I've been experiencing vaginal dryness for several months and I've used everything I can think of to stay lubricated during sex with my husband -- KY jelly, fatty acid supplements, even saliva. All of those tricks work but only for a little while before I become dry again. Now sex is almost always painful, and afterwards Išve been noticing small abrasions on my genitals. How can I enjoy sex again?

Dr. Donnica: There are two very important components to vaginal lubrication: physical and emotional excitement. Assuming nothing has changed in your lovemaking techniques or in your level of attraction to your husband, you should discuss physical causes for this problem with your gynecologist. Unfortunately, you're in a vicious cycle now: Your brain is anticipating that you won't be lubricated enough for pleasurable intercourse, causing anxiety and stress, which can further diminish the likelihood that you will become lubricated! This is not your fault!

When non-prescription vaginal moisturizers or lubricants don't help, the most common explanation for vaginal dryness is low estrogen levels. This is usually associated with menopause or perimenopause. Perimenopause is the precursor to menopause. It is the two to 10 year period that may precede menopause during which you may have menopausal symptoms despite continuing to menstruate. Depending on your age and your medical history, as well as whether you have any other symptoms, your doctor can prescribe a vaginal estrogen cream which can be very effective. Another alternative would be an estrogen pill or patch, most likely combined with a progestin.

Until you have a chance to see your gynecologist, I recommend postponing intercourse until the genital abrasions have a chance to heal. This will give you an opportunity to creatively explore other ways to enjoy your sexual relationship that aren't painful to you.

Created: 6/13/2003  -  Donnica Moore, M.D.

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