Question

Sex with my husband is painful because I’m “all dried up down there.” My doctor told me it happens to older women. What can I do to address my vaginal dryness?

Answer from OB-GYN Karen Carlson, MD 

It’s very common for women to have a lower sex drive, or libido, during menopause.

Common menopausal symptoms caused by decreasing hormone levels are often to blame for a lower sex drive. Body discomfort or weight gain can take away your desire for sex. Hot flashes and night sweats can make you tired. Mood symptoms, including depression and irritability, can cause relationship turmoil. Each of these symptoms can make sex less enjoyable, leading to lower libido.

Decreased blood supply to the vagina can cause vaginal dryness, tightness or loss of elasticity and make sex painful.

You can increase your sex drive with lifestyle changes, including date nights, sex aids and lubricants. Local estrogen therapy – using vaginal rings, suppositories and creams – helps vaginal dryness and loss of elasticity. Taking an oral pill can reduce dryness in the urogenital tract and reduce pain during sex.

Some women choose systemic hormone replacement instead of local estrogen therapy. You can opt for a pill or a patch.

Usually, it contains estrogen with or without progesterone. Hormone replacement therapy is only recommended at the onset of menopause and only for a short time, roughly five years. But, for women who are not on hormone replacement therapy or are not candidates for this, they almost inevitably will need to use some form of treatment for the genitourinary syndrome of menopause.

Some women prefer over-the-counter personal lubricants, which you can use regularly to help moisturize the vagina. You can also use lubricants during intercourse.

The bottom line: Tell your doctor how you’re feeling. They can help you enjoy sex again and minimize the symptoms of menopause.

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These are anonymous questions, meaning we can’t give one-on-one medical advice in this format. For medical advice specific to your unique condition, schedule an appointment at 800.922.0000.