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Posts Tagged ‘vaginal comfort’

It sounds like what you’re experiencing is “bridging.” There’s a “bridge” of tissue at the base of the opening of the vagina. When stretched, it will occasionally separate or tear. As we lose estrogen through menopause, those tissues lose elasticity; there’s also narrowing of the opening of the vagina.

A very successful solution is a “perineoplasty,” a surgical modification of that tissue. Like a small episiotomy (sometimes done in labor to ease childbirth), it involves a small incision and repair to relieve pressure. In this case, the repair is made from front to back rather than from side to side.

This procedure is done in the office, under a local anesthetic, with just a few absorbing stitches. In my experience, it’s very successful and much appreciated by women. Keeping things comfortable will often require some combination of localized estrogen, vaginal moisturizer, and a lubricant with intercourse.

 

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You say you’ve been using Replens regularly, and have noticed that hydrogenated palm oil is among the ingredients. You’ve heard that hydrogenated fats are unhealthy, and wonder whether you should be concerned.

You’re right to be concerned about ingesting hydrogenated palm oil in food products, especially if you have elevated cholesterol and triglycerides. As an ingredient for a topical product, though, like a vaginal moisturizer, the oil is safe and won’t affect your lipids. Applied to the surface of your skin or tissues, the moisturizer is not absorbed into your bloodstream.

Keep using that moisturizer! Keeping tissues health goes a long way toward comfort and enjoyment.

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It sounds like you’ve done a great job with regular, sustained use of dilators to restore the vaginal opening. Be aware that the top of the vagina tapers a bit, so it’s possible that the largest-diameter dilator, because of its width, just won’t go in as far as the others. The only way to assess for certain what’s happening is to have a pelvic exam with your health care provider; I’d explain to her or him that you’ve been using dilators and see whether s/he finds anything other than normal.

During intimacy with a partner, many women find that they can control the depth and angle of penetration more easily when they are on top. That seems to be a safer starting point for women who have reason to better understand what’s most comfortable–and pleasurable.

Congratulations on taking care of yourself!

To ask your own question, use the pink “Ask Dr. Barb” button top and center on our website. You’ll receive a confidential reply via email, and your question may be used as the basis for a Q&A post here on our blog. 

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Whether you’re using a cream, tablet, or ring to add localized hormones to your vagina, your partner is not absorbing any—no more than he did when you were producing your own hormones before menopause. You (and he!) can feel perfectly confident about your use of these products, and your intimacy will benefit from the increased comfort you’re likely to experience.

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If you can comfortably insert any size tampon, you don’t need much more space to allow for intercourse. I use two fingertips as a rule of thumb; that is, if I can insert index and middle fingers during an exam, I can assume intercourse is likely to be comfortable. The only time I’ve done surgery to enlarge the vaginal opening was when only a Q-Tip could be inserted–a definitive intact hymen.

What you might find helpful is vaginal dilators to help to extend the elasticity that you already have. The graduated sizes of dilators, regularly used, can gently stretch the tissue to assure comfortable penetration. I’d certainly try that before opting for surgery!

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Dilators are not intended to fit all the way inside your vagina. The extra length gives you some space to hold on to and to apply gentle upward pressure. The pressure gently stretches the tissues to achieve additional length or depth in your vagina.

The graduated diameters of the dilators in the set are intended to address narrowing of the vagina. Use the smallest one until it’s comfortable, and then move to the next-larger size. We offer a more complete description of how to use dilators on our website.

I also encourage the consideration of vaginal moisturizers and localized estrogen to help keep the tissues healthier and more supple. That in combination with the dilators can give you more comfortable, faster, more lasting results.

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The odor and discharge that you describe sounds most consistent with bacterial vaginosis; it’s not a result of your partner’s medications. This infection is not serious or particularly worrisome, but the symptoms are certainly a major annoyance!

You could first try RepHresh, a product that may alleviate the symptoms by correcting the vaginal pH (you can read more about pH in this recent blog post). Vaginosis can also be treated with an antibiotic, administered orally or vaginally.

Douching is not helpful and can be harmful: It disrupts normal bacteria in the vagina and makes you more susceptible to infection.

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