Let’s discuss the methods of lubricating the vagina to reduce trauma during intercourse. This is important to prevent friction, pain and even tearing of the skin around the vaginal opening. Failure to consider this can lead to pain on insertion or “dyspareunia” which causes some women to begin avoiding intercourse or even sex altogether.
If the dryness is due to menopause and estrogen loss, this can lead to atrophy or dry, non-stretchy, thin skin. The cause is the loss of fat cells under the skin which is usually maintained by adequate estrogen levels during younger years. The problem generally worsens with age unless it is treated. This can be easily treated by using estrogen cream or tablet in the vagina. When used in small amounts, the estrogen works locally and does not have any major impact on the estrogen levels of the blood. Besides creating lubrication and improving elasticity, it also improves the tissue around the bladder and urethra. This is a safe therapy for almost every medical condition. For those who do not want a medication, one study suggests that three orgasms per week can maintain the youthfulness of the vagina without therapy.
Dryness due to inadequate lubrication as a side effect of medication or simply due to lack of arousal can be treated with numerous over the counter lubricants. There are water-based lubricants such as K-Y liquid or Astroglide; mineral oil- based lubricants such as baby oil and Vaseline (beware that these are not safe with condoms as they break down the integrity of the condom); and finally silicone-based lubricants such as Eros or Wet Platinum which maintain wetness longer. Zestra is a mixture of botanical oils that works well, too. Beware of K-Y intense or K-Y warming liquid in the menopausal vagina as these may cause burning.
For those trying to conceive, a lubricant called Preseed does not interfere with sperm motility.
Finally there are vaginal moisturizers such as Replens, RePHresh and K-Y liquibeads which when inserted vaginally maintains moisture for about 3 days.
This is a brief overview of products available to enhance sexual intimacy and reduce pain. For more detailed information contact your physician or call us at the Center for Sexual Health and Education.