Hi Momma bear,

I’m so sorry to hear about your pain!

I think that your gyn giving you the estradiol cream was on the right track, as being on the pills for so many years will make the tissue at the vaginal entrance more sensitive to tearing and the lack of hormones is usually the culprit. When i give the topical estrogen (or usually I give a compounded estrogen/testosterone cream) i always direct my patients to rub the cream directly into the posterior fourchette and massage it into the area until the cream is absorbed. This helps with the mess factor and also helps to treat the problem area directly. Many of my patients are advised to insert the estradiol cream with the applicator deep into the vagina, but that doesn’t really help as much as just rubbing the cream right into the vaginal opening, and then you have the drip factor, which you avoid if you just rub the cream in.

You might also really benefit from dilation therapy to slowly stretch the vaginal entrance to help prevent tearing.

Botox would help with muscle tension, but won’t help heal the tissue if it is impacted by lack of hormones.

Hope this helps. Melissa