Medically Reviewed by Paul E. Chandler, MD

Women and their partners are often faced with vaginal dryness after a hysterectomy or after a woman is past menopause. McLeod Gynecologist Paul Chandler, MD, discusses what you can and should NOT do to help the problem:

Here are key points from Dr. Chandler:

When a woman has a “total hysterectomy” — where everything (uterus, fallopian tubes & ovaries) has been taken out, the amount of estrogen left in the body is low. That causes the lining of the vagina to thin and become less elastic. That is called “vaginal atrophy.”

When the vagina becomes dry and less elastic, painful intercourse can result. The woman’s vagina will be dry and will not stretch. Also, those tissues tend to scar and shrink from lack of estrogen.

One of the treatments for this development would be to use some vaginal estrogens. Very little of it gets absorbed. So, it’s very safe. I’ve even used this treatment for women, who’ve had breast cancer, because there’s so little of the estrogen that is absorbed. But it does thicken those vaginal tissues up and makes them more elastic, helping reduce painful intercourse after hysterectomy.

Sometimes a woman might have very bad endometriosis. This condition is where some of the blood and uterine lining from a woman’s period, rather than going through the vagina, it goes through the fallopian tubes and ends up in the woman’s abdomen. The lining is still alive and can implant on the pelvic organs, causing scarring of those pelvic tissues. Even though this woman has had a total hysterectomy and had all the organs removed, the scar tissue can recur. During intercourse, there can be pain from the manipulation of that scar tissue.

In post-menopausal women or women who have had their ovaries removed and have low estrogen levels, a vaginal lubricant for sex helps a lot.

Don’t use Vaseline, because that can actually make the pain worse. Don’t use K-Y Jelly; this lubricant is designed for office examinations.

Use a water-based or a silicone-based lubricant. A good one that I recommend to patients is called Astroglide. (You can find that at Wal-Mart). The best ones are water-soluble lubricants, and they make a huge difference for those women in menopause or those women who have had a hysterectomy and no longer have adequate estrogen levels.

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