Dyspareunia: The Menopausal Problem No One Talks About

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    Hi ladies. I came across the following article: Dyspareunia: The Menopausal Problem No One Talks About


    “The problem of dyspareunia during menopause is a topic most women don’t want to talk about, but this condition affects up to forty-five percent of women at some time during their menopausal years. Dyspareunia is the medical term for pain during sexual intercourse; and, unfortunately, this condition is on the rise as more women choose not to use hormone replacement therapy. The problem of dyspareunia can be especially trying for women since men are staying sexually active later in life with the help of medications such as Viagra. Some women never seek treatment for this condition due to embarrassment or the belief that nothing can be done to help their symptoms.

    What Causes the Symptoms of Dyspareunia?

    Dyspareunia is most frequently caused by declining estrogen levels which causes a condition called atrophic vaginitis. As estrogen levels fall, the lining of the vagina starts to thin and produce less lubrication which makes intercourse more painful. Women who haven’t had children, those who smoke, and those with lower estrogen levels have the most severe symptoms of dyspareunia. Symptoms of atrophic vaginitis include burning, itching, and, occasionally, a vaginal discharge. The easiest way to treat this condition isn’t always the safest – estrogen supplementation – which most women want to avoid due to the risks and side effects.

    Other Causes of Dyspareunia

    The problem of dyspareunia isn’t always related to atrophic vaginitis. Infection in the vaginal region, urinary tract infection, and even some types of vaginal skin conditions can be associated with dyspareunia. Some creams, lotions, or birth control products cause irritation in the vaginal region which can lead to discomfort with intercourse. Some women also experience dyspareunia from painful spasms of the vaginal muscles when intercourse is attempted. This can be due to anxiety or even a history of sexual abuse. Sometimes endometriosis or a tumor in the pelvic area can give rise to dyspareunia. Because there are so many potential causes, it’s important to get this symptom checked out by a doctor.

    Treatment of Dyspareunia: What Works and What Doesn’t

    Estrogen replacement therapy isn’t always the answer to treating dyspareunia even if a woman is willing to overlook the health risks. Only about one in four women experience relief from the symptoms of dyspareunia when they start estrogen replacement. When the symptoms are due to atrophic vaginitis from lack of estrogen, using lubricants can make a difference as can keeping the vulvar region moisturized. Some sources recommend certain herbs or phytoestrogen containing foods and creams to relieve the symptoms of dyspareunia, but there’s little evidence that they work. Sometimes simply changing position during intercourse can make the experience more pleasurable and less painful for women with dyspareunia.

    For women who have symptoms of dyspareunia due to spasms of the vaginal muscles, special exercises used to train the vaginal muscles to relax can help as can stress relief techniques. A new treatment for vaginal muscle spasms is the use of Botox. Preliminary studies show that it’s effective for many women and has few side effects.

    Dealing with Dyspareunia: The Bottom Line?

    Don’t let the problem of dyspareunia keep you on the sidelines. Find out why you’re having it and get appropriate treatment.”

    Dr. Pack has written an excellent blog concerning Menopausal Vaginismus:


    He writes: “intercourse is possible but often results in pain and burning after, which is called dyspareunia. Artificial lubricants seem to do a poor job replacing natural lubrication. As the condition gets worse, the patient appears to develop vaginismus, and when examined, appears to have the same spasm of the entry muscle as seen in the primary vaginismus patients.The spasm can be treated with the Botox program, which includes Botox vaginal injections and progressive dilation under anesthesia together with post procedure counseling as is done in our primary vaginismus patients.”

    I encourage you to read the article on dyspareunia and Dr. Pacik’s blog and I welcome your comments and feedback here.

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