Love & Sex

Is Dryness Sabotaging Your Sex Life?

When young women are sexually aroused, vaginal lubrication flows easily from the vagina’s blood vessels through its tough, elastic lining. Plenty of estrogen and testosterone in our systems kept these tissues strong and healthy, making this process automatic. As estrogen levels decline, the vaginal lining changes, becoming less stretchy and more delicate – much like our skin. Blood vessels, muscles and surrounding tissues all become less responsive over time.

As we age, our testosterone levels drop too, lowering our sexual desire and drive. At age 60, we have about 50 percent less testosterone than we did at 25, our peak. When lack of desire and painful penetration reduce the number of sexual encounters, the vagina responds by losing its elasticity and responsiveness even faster.

If you don’t use it, you lose it.

Vaginal dryness can progress to vaginal atrophy, the thinning and weakening, shortening and tightening of the vulvo-vaginal tissues. It’s the most common cause of pain with intercourse after menopause, experienced by more than half of us. In addition to vaginal dryness, it can give us vulvar pain, discharges, pain or stinging with penetration, tearing or bleeding of increasingly delicate skin, and a variety of issues with urination.The net effect: After menopause, we can pretty quickly lose our ability to lubricate our own vaginas, which can become quite sensitive and prone to tearing. All of which can be quite painful and cause us to avoid having intercourse.
But when we stop having penetration with sex, vaginal changes happen more quickly. Regular sex, including penetration, either alone or with a partner, increases blood flow to the vagina and surrounding tissues. Without it, we’re more likely to have tiny abrasions from friction, causing the walls of the vagina to stick together or even close in some places.

What to do.

If you enjoy sex and want to have it as part of your life, then keeping your vagina well moisturized and healthy is just one more piece of your body maintenance routine. It’s no different than moisturizing your face to prevent wrinkles or conditioning your hair to keep it soft.

In your fight against vaginal dryness, your two best friends are (1) lubricants to use during sex and (2) moisturizers to use between sexual encounters to keep your vagina moist.

* Sexual lubricants for women coat the vagina to ease penetration, which adds comfort during intercourse. They provide a benefit at the time of use only. You may need to experiment to find the right vaginal lubricant for you (MiddlesexMD offers a good selection), but you’ll be pleasantly surprised once you’ve found your favorite.

* Moisturizers (like Yes) are designed to be longer lasting. They replenish and help maintain water content in the vagina, clinging to the vaginal walls so they are effective for several days.

What not to do.

Do not use packaged douches to treat vaginal dryness. These will make matters worse by robbing your vagina of its healthy flora. Do not use hand lotions, mineral- or vegetable-oil based moisturizers, vinegar, or yogurt as moisture replacements. They can cause irritation and may contain ingredients that will work against your healthy pH level. In short, if it wasn’t designed specifically for vaginal use, don’t use it in the vagina.

One extra note.

Your most critical sexual organ is your mind. When you’re not in the mood for sex, or you’re not aroused enough for sex, all the lubricants and moisturizers in the world won’t make the experience pleasurable. Our bodies, at any age, must be open to the experience before we can enjoy penetration or even clitoral stimulation. At 60, that will usually take longer than it did when we were younger. Give yourself time, and ask for time from your partner to allow both your mind and your body to engage before sex.

Dr. Barbara DePree

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