If you’ve read enough of my past blogs, you’d think the whole world is experiencing dry, painful intercourse — and that without the benefit of a great lube, a local vaginal estrogen, ospemifene (a non-estrogen oral medication), or a CO2 laser treatment, women are doomed to a destiny of sandpaper sex or no sex. But that’s not the case.
Before menopause, the majority of women don’t require anything other than the occasional lubricant. Post-menopause, only about half of women have lubrication trouble.
So what separates the two groups: Good genes, good diet, or good luck?
When it comes to vaginal elasticity and lubrication, a number of factors besides estrogen and age have a role. Certain medications have a negative impact, for example, and women who’ve never had a vaginal delivery are more likely to have vaginal tissue that becomes dry. Other contributors to a lack of lubrication are inadequate blood flow to the vaginal walls due to the normal aging process, a medical problem such as diabetes, and cancer treatment.
Another factor beside age, medical problems, and luck is the value of regular use.
Vaginal Lubrication and Regular Intercourse
Regular stimulation of vaginal tissue helps maintain blood flow, which in turn increases lubrication and elasticity. And that’s where “use it or lose it” comes into play.
Women who have had a long sexual hiatus are more likely to experience vaginal dryness than women who are regularly having intercourse.
So what’s a woman to do when she’s between partners, or has a partner who’s out of business, to keep her tissue from drying up?
In many cases, the changes destined to occur from lack of use are preventable. You may have to get creative and be consistent about stimulating blood flow. Regularly inserting a dildo or a vibrator should help maintain vaginal lubrication and elasticity. And just like going to the gym, you will probably enjoy it once you get started!
Of course, if your vaginal tissue is already very thin and dry, a little repair work may be in order in the form of a prescription product like vaginal estrogen. One of the most common questions I get when I prescribe a local vaginal estrogen is, “How long will this treatment be necessary?”
In general, my answer is “forever,” because once the treatment is discontinued, the vagina will become thin and dry again. But in my experience, for many women who have had a long hiatus, a local vaginal estrogen repairs the situation and they maintain vaginal elasticity by regular stimulation — they don’t need to continue using a prescription.
So if you have no pain, but alas, no partner, stimulate with a device to keep things good to go. Use it or lose it.