By far the most common cause of painful intercourse in a menopausal woman is vulvar and vaginal atrophy. During menopause estrogen levels plummet and can result in severe vulvar and vaginal dryness. Some of my patients have described intercourse as feeling like someone was rubbing sandpaper in their vagina. Another patient described her vagina as a “rigid container.”
Treatment for vaginal atrophy secondary to menopause has mostly been limited to estrogen based medications in the form of creams, rings and tablets. There are some women for whom estrogen is contraindicated and I have had patients who don’t like inserting anything into their vagina. Luckily, these women now have another option.
Osphena is the first non-estrogen oral medication that has been FDA approved for the treatment of painful intercourse due to menopause. Although it is an oral pill, it works on a cellular level in the vagina by increasing the number of superficial cells. These superficial cells are what provide the moisture and elasticity. Once these cells regenerate and moisture and elasticity return, intercourse should not be painful.
Since this is a new medication, I cannot comment on its effectiveness yet. I am very encouraged though that new treatments are becoming available for women’s sexual health. As I’ve said many times before, intercourse should not be painful!