Many causes for painful intercourse

Q: Sexual intercourse has become very painful since stopping HRT (Hormone Replacement Therapy). I've tried progesterone and Vagifem, but nothing helps. I think this is a concern for many women. Do you have any other suggestions?-- E.K., Ocala, Florida

A: Indeed, many women have this problem, especially older ones who experience vaginal dryness while going through menopause. Some women also take certain medications that lead to vaginal dryness, including antihistamines used for allergies, tricyclic antidepressants and, believe it or not, birth control pills.Younger women who still have a menstrual cycle may experience painful intercourse because of endometriosis, a condition that usually includes severe cramping and back pain during menstruation, painful bowel movements, fatigue, spotting and difficulty conceiving.The quick fix for vaginal dryness is a lubricant, easily found at any major retailer, health food store, or pharmacy. Brand names include AstroGlide, K-Y, LifeStyles, Replens, Zestra and others.Some of these inexpensive products are "warming," while others are "cooling." These effects are intended to heighten sensation and reduce friction. Personal lubricants only work temporarily and won't help every couple because painful sex may have nothing to do with vaginal dryness. That's why doctors may need to get involved for a proper diagnosis. I always suggest taking oral vitamin E, about 400-800 IU daily, which also nourishes hair and skin. In addition, omega 3 fish oils (1,000 mg once daily) are important for the same lubricating reasons.Another consideration is your hormones. Ask your OB/GYN if you have lower levels of thyroid, estrogen or testosterone -- three hormonal issues that could also lead to vaginal dryness. You can buy your own hormone test kit at zrtlab.com.Getting your hormones balanced is really important, and I can't stress this enough. Speaking of stress, if your life is riddled with hassles and obligations, dominated by a never-ending "to-do" list (welcome to Earth), consider Panax ginseng. This oriental herb supports adrenal function so you can cope, but it also helps men and women boost sex drive and reduce painful sex (because it thickens vaginal mucosa). Panax ginseng is a terrific option and is considered very safe, but it doesn't work overnight. Be compliant --dosages vary, but 400 mg every morning is a common dose. It's fine to take with vitamin E and fish oils, too.Readers alert: A batch of griseofulvin oral suspension used to treat fungal infections has been recalled because of glass fragments in the bottle. Consumers can call (800) 510-0383 to check lots.This information is not intended to treat, cure or diagnose your condition. Suzy Cohen is a registered pharmacist. Her column is published Tuesdays in the TimesDaily.-To contact her, visit dearpharmacist.com.
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