Vulva atrophy

[vey999]

So while everybody here is worried about their penis, what's going on with your wife or partner?

Turns out that she's not doing so well without sex either, and her post-menopausal vulva is atrophing while you are not having sex.

So when I wanted to try my new penis, I heard "ouch!' So far my "solution" is to pump up a little, insert and then pump up more,but I'm open to suggestions.

[ThePlumber1964]

She can ask her Gynecologist about solutions for post menopausal dryness.

[Lost Sheep]

You seem to have the first, most important elements, patience and caring. Good for you.

During sex, foreplay prepares her tissues with lubrication and slow stretching, as does your technique of post-insertion inflation.

Additional lubrication will also help.

During non-sexual times, she can stretch her own tissues with stents. E.g. After male-to female genital surgery, the patient uses vaginal dilation stents in graduated sizes to gradually stretch the vaginal tissues, else they will contract and sex will be impossible. I think the stents must be a regular routine for lifr for the trans woman

(Edited to add:) Very well said, AussiRJay

[AussieRjay]

I am not a doctor, but from what I understand the vagina, like the penis, is a use or lose organ, especially after menopause. Lack of oestrogen causes atrophic changes to the tissues. If a post menopausal woman goes without sex long enough, the vaginal canal itself can stenose to the point where it can be uncomfortable or downright impossible to penetrate. Ironically, regular sex can prevent this to some extent.

If a couple has gone without sex for that length of time then, prior to the man having an implant installed, it might be sensible for both partners to be medically examined and advised. Some couples counseling might not be a bad idea either. I'd like to think that uros are advising men (or couples, if they've attended together) of this prior to implant but from the above it seems not, or at least not always.

There are treatment options such as HRT and vaginal dilators for the physical side of things - but the reason I suggested counseling as well is that there will likely have also been psychological adjustments made by the woman over time (just as ED has profound psychological effects on we males).

It would be saddening for a return to intimacy to be marred by pain and difficulty for her, and at worst it could put her off the whole idea. Trip to the doc is in order I'd say. Whether you go together or she goes alone would I think be a matter for her. She may feel pressured in a joint setting, but you guys likely know your wives well enough by now to know what she needs.

[AussieRjay]

A quick websearch turned up this useful summary:

http://www.medicalnewstoday.com/articles/189406.php

[vey999]

"however, many women do not actively ask that medical attention be paid to this, possibly because it is naturally caused, or because of the taboo that still exists surrounding aging and sexuality."
-from the article

That sums it up pretty well. I can pester, but if she doesn't care enough to talk to her doctor about it, there is not much I can do. Lube didn't help much.

Kind of a bummer.

[Lost Sheep]

"however, many women do not actively ask that medical attention be paid to this, possibly because it is naturally caused, or because of the taboo that still exists surrounding aging and sexuality."
-from the article

That sums it up pretty well. I can pester, but if she doesn't care enough to talk to her doctor about it, there is not much I can do. Lube didn't help much.

Kind of a bummer.

If you can keep giving her orgasms by other means (tongue, hands or toys, etc) or by your current "workaround", she may eventually decide the embarrassment of asking a medical professional is a s all price to pay for the orgasmic rewards.

In the meantime, you can view this through the tragic lens of Faust or the with the gentle humor of O. Henry. Your choice, but I suspect from the tone of your original post, that your love for each other will rise to the occasion.

Blessings to you

[TANGERINE]

here are two good sources of information:

(The google search word is: "postmenopausal dyspareunia")

https://www.menopause.org/for-women/sexual-health-menopause-online/effective-treatments-for-sexual-problems

Also, here is an excerpt from an article: "When Sex Hurts"
REFERENCE: http://www.healthywomen.org/print/1473

When Sex Hurts

Posted on: 22 September 2009
By: jleff
Between 25 percent and 45 percent of postmenopausal women find sex painful, a condition called dyspareunia.

While there are many causes, the most common reason for dyspareunia—painful sex—in women over 50 is vulvovaginal atrophy, a fancy name for a vulva and vagina that no longer have the beneficial effects from estrogen that they did prior to menopause.

Lower estrogen levels significantly affect your vagina, impacting its ability to secrete lubricant, to expand and contract and to grow new cells. Over time, blood flow diminishes, and the vagina and vulva can atrophy, or shrink, as cells die off and aren't replaced.

The result? Soreness, burning after sex, pain during intercourse and, sometimes, post-sex bleeding.

The good news is that vuvlovaginal atrophy is very treatable. One of the best treatments doesn't involve medicine! Turns out that the more often you have sex, the less likely you are to develop atrophy or, at the very least, a serious case of it. That's because sex increases blood flow to the genitals, keeping them healthy.

Other treatments include:

Estrogen. As you might expect, if lack of estrogen is behind vulvovaginal atrophy, then giving back estrogen should help. Both systemic estrogens (oral pills and patches) and local estrogens (creams, rings and tablets applied to the vulva and/or vagina) work. However, most major medical organizations recommend starting with the local approach first because it keeps the estrogen right where it's needed, limiting any effects on the rest of your body.

Studies on the estrogen ring, cream and tablets find extremely high rates of improvement in dyspareunia, with up to 93 percent of women reporting significant improvement and between 57 percent and 75 percent saying that their sexual comfort was restored, depending on the approach used.

Side effects vary. Most estrogen products applied locally are associated with minimal side effects. However, each woman's response can differ. When using estrogen creams, pills or rings, it is important to talk to your health care provider about any symptoms, such as: headache, stomach upset, bloating, nausea, weight changes, changes in sexual interest, breast tenderness, abdominal pain, back pain, respiratory infection, vaginal itching or vaginal yeast infections.

If you have had breast cancer or a family history of breast cancer, be sure to discuss your history with your health care professional, if you're considering using estrogen. Your health care professional likely has covered this topic with you already.

Non-medicated lubricants. If you'd rather not go the estrogen route, consider using some of the over-the-counter products designed to increase sexual comfort. Vaginal lubricants come in liquid or gel form and work by reducing friction. You can apply a water-based or silicone-based lubricant to your vagina and vulva (and, if desired, to a partner’s penis) just before sex. You may also try longer-lasting vaginal moisturizer, which is absorbed into the skin and can provide relief from vaginal dryness for up to four days.

Other Causes of Sexual Pain

Since many women over 50 do not experience vulvovaginal atrophy, women with sexual pain should be aware that there are other medical conditions that could be responsible for their symptoms. These include:

Vestibulodynia. Vestibulodynia is the most common cause of sexual pain in women under 50, but it can also affect older women. Women with this condition feel severe pain when any type of pressure or penetration is attempted at the entrance to the vagina (an area called the vestibule). It is treated with topical anesthetics, estrogen cream, antidepressants, antiepileptic drugs (often used for nerve-related pain) and physical therapy. Look for a physical therapist who is specially trained in pelvic therapy.

Vulvodynia. This condition involves stinging, burning, irritation, rawness or pain on the vulva, the tissue that surrounds the vagina. The pain and irritation can occur even when nothing touches the area and is likely related to abnormal nerve firing. Vulvodynia is treated similarly to vestibulodynia.

Vaginismus or Pelvic Floor Muscle Dysfunction. In this condition, the vaginal and perineal muscles involuntarily spasm with attempted sexual activity. This can make vaginal entry very difficult or even impossible. Vaginismus can occur after a trauma (such as nonconsensual sex), or it can be related to underlying physical conditions, including musculoskeletal injuries or vestibulodynia. Vaginismus is often treated with dilator therapy (in which women are taught relaxation techniques while using progressive-sized dilators in their vagina) and physical therapy.

Urinary tract conditions. Cystitis, which involves inflammation of the bladder, is a common cause for painful sex, because the bladder sits on top of the vagina and can be aggravated during sex. There are several kinds of cystitis. Chronic interstitial cystitis is a painful bladder syndrome that causes bladder pressure, bladder pain and sometimes pelvic pain. Acute cystitis is a bacterial infection of the bladder or lower urinary tract that occurs suddenly and causes pain—often referred to as a urinary tract infection (UTI). In postmenopausal women, lower estrogen levels change the pH and make bacterial infections more likely. Lack of estrogen also can make the vagina more vulnerable to vaginitis, including bacterial vaginosis and yeast infections. Both can cause pain and itching.

Other causes. A uterus that has "dropped" or prolapsed may cause pain during sex. Endometriosis, a condition in which the uterine tissue grows outside the uterus, usually ends after menopause but may continue in women taking estrogen and can cause pelvic pain. Sexual trauma and childbirth trauma, such as episiotomies or tears and repairs, may also cause painful sex.

Time to Speak Up

Unfortunately, most women do not talk to their health care providers about sexual pain or problems, nor do their health care providers bring up the topic. In an international survey of 391 women by the Women's Sexual Health Foundation, fewer than 9 percent of women said their health care professionals had ever asked if they had sexual problems.

If you don't bring up the topic of sex with your health care professional, it may not get addressed. Talk to a gynecologist or urogynecolosist about your sexual pain. They can offer the most options for treating this complex problem.

[alibaba]

So while everybody here is worried about their penis, what's going on with your wife or partner?

Turns out that she's not doing so well without sex either, and her post-menopausal vulva is atrophing while you are not having sex.

So when I wanted to try my new penis, I heard "ouch!' So far my "solution" is to pump up a little, insert and then pump up more,but I'm open to suggestions.

Wife had vagina atrophy after my prostatectomy. Shrank and I could not get it in any more. We talked to Dr. Stephen Brandes about it and he prescribed her a steriod creme to get the flex back in it and all was fine, no creme needed after a couple months. She would have been 56 then.

[ThePlumber1964]

This happens not only to post menopausal ladies. There are some kinds of infections that may not create a big red flag symptom, but at very early ages they will experience the same problems.