FACTORS AFFECTING YOUR SEXUAL LIFE: WHAT CAN BE DONE ABOUT THESE SYMPTOMS?
This depends on the severity of your problem.
Simple measures Some women manage well with a lubricant cream such as KY jelly.
Local oestrogen creams and pessaries For those who do not want oestrogen tablets for general symptoms, and indeed a dry vagina may be their only symptom, local oestrogen creams or pessaries are the answer. Some patients feel these creams are unaesthetic and messy. If these are used, however, the absorption may be the same as if a similar dose is given by mouth and progestogens therefore should be given at regular intervals to shed the built-up lining of the uterus.
Oestrogen replacement therapy This cures vaginal dryness dramatically in 100 per cent of cases if this is due to oestrogen lack, and the result is obtained within weeks. The dose for this symptom alone is small and would certainly be your choice if other methods have failed. Vaginal dryness is a common symptom, and those doctors who deny that it is, I feel, do not enquire about it. It is important for doctors to be aware of people’s reticence in discussing such matters. This symptom has such a profound effect on marriage, and is so easily relieved.
The case history could be included here of a woman I saw twenty years after her ovaries had been surgically removed for endometriosis. With the removal of her ovaries her oestrogen production had stopped and she was suffering from lack of oestrogen. She was downcast and depressed, and she had not had intercourse for 14 years. On examination, her vagina was so constricted that I could introduce only a cotton bud to take a smear at routine examination. She complained that she was so dry and irritable in her vaginal area that she could hardly sit still. After a fortnight of oestrogen taken orally and applied locally I could readily introduce a bi-valve speculum. Her vaginal tissues had reverted to normal and she was happily having intercourse. The effects of the treatment are as rapid as that.
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