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[Momo]

Hello Menopause Mavens!
I pop in now and again to get support from you amazing people and it always help. I am wondering if i have VA and whether to ask my Doc for Shensio when i see her later this month? Or whether it is something else.
This is a bit of a saga but here goes.
After first trying HRT several years ago i stopped as i didn't feel any better/ Migraines were awful etc. and then i tried again last October( 2022)
I had been on HRT ( Evorel 50 mg, Utrogeston and Testim gel) for about 7 months, felt okish Migraines a bit better but started to get heavy bleeding and have been advised by GP to come off. Since stopping all that about 2 months ago , there has been no bleeding , some migraines but not too bad and the only thing that still  really bugs me my inability to have sex, its so painful. The same for smear tests - but this has largely always been the case.
The reason i question if its VA is that it doesn't hurt at any other time. Some of the descriptions i have read describe more or less constant pain, pain sitting down, pain weeing etc and UTI feelings. But ( touching wood here) I don't get any of that , its just when something is put inside me, so no to any gels, pessaries, tampons, fingers, speculum, vibrators - any of that has me crying in such pain.
I had a hysteroscopy this week to check that the bleeding wasn't anything to worry about ( hadn't bled for 7 years)  and they struggled to find my cervix - quote - 'this might explain why smears have always been so bad'  they just about found my uterus - I was suckling on gas and air like a piglet on a teat at this point, and could confirm my womb lining was only 2.6mm so within safe limits.  So i need to decide what can help me able to have sex with my husband.

The consultant suggested trying a dilator but how do i get over the pain? Has anyone here used dilators to help with VA. Have I always had VA and not known? Or do i not have VA at all ? - lots of questions but I am feeling a bit lost

 i haven't felt too bad emotionally, even managed to come off the Anti Depressants last November - with a few emotional days but not too bad. ANYWAY- having read in Davinas book and some threads on here about VA - I don't recognise the things described. If i have had this since i was 13  and trying Tampons  I used to be able to have sex with my husband with a lot of lubricant and a lot of patience and it wasn't too bad, but I am 53 and don't think i have every had pain free sex yet . I just used to be able to bear it for the pleasure i could get eventually. But i don't want to give up!

Does anyone else recognise these symptoms? Is it VA? And  are dilators and the feared pain, my only hope?
thanks for any help you can give and sorry for the really long waffle
cheers
M

[Flossieteacake]

So sorry to hear of what you are going through. I was wondering if you may have vaginismus rather then VA? The reason I ask this is because you have pain with penetration and not other symptoms.

I have used dilators to try to help me because I am very narrow and find it hard to insert applicators. I bought the smallest one from Soulsource. It took me quite a few months before I could use it with ease but due to VA pain I stopped using it and have to start all over again. If you do wish to use one I would use lots of a moisturiser you can tolerate, I used Yes and only insert the very tip in until you are okay with that.

This can often be a phycological issue so you may find it helpful to talk to a therapist that specialises too. Please do not worry. There is hope and things can improve for you.

[Momo]

Thank you Flossieteacake
I will continue to research, and thanks for taking the time to advise
all the best
M

[CLKD]

Sometimes the body tenses up when sex is attempted, this is usually a problem in our earlier years.  R U able to examane yourself in the bath when more relaxed, when washing in warm water? Finding out about yourself in private maybe a starting point.

Vaginal atrophy can present in many guises  4 me it was like razor blades up there!  After investigations for urine 'infections' my GP recognised symptoms of VA and prescribed 'ovestin' over the phone.  No examination required.

If the body tenses up - there are other ways of sexual contact without penetration i.e.  ;-).  This doesn't need to be inserted.  I was never able to insert 'tampax' fully as I have a short vagina.  Apparently.  Never been a problem for either of us ;-).

What is Shensio? 

[Momo]

thanks CLKD - I meant Sensio - https://bnf.nice.org.uk/drugs/ospemifene/ also known as Ospemifene
A menopause practitioner that i was seeing suggested it , as i can't put anything up there. And it can be prescribed for people who can't have local  vaginal oestrogen but i think its really expensive so GP's don't like prescribing it as a first choice.

We have used alternative vibrating  methods  in the past , but even that hurts now. Probably a connection with sex being painful, so now its become a thing.

Looking around yesterday i did wonder if it Vestibulodynia - https://vulvalpainsociety.org/about-vulval-pain/vulval-pain-conditions/vestibulodynia-formerly-vulval-vestibulitis/
There isn't any spasm or tension when anything is placed in the vagina. There is just a terrible stinging pain a the approach to the entrance, like someone is burning and cutting me at the same time.

Am going to keep researching and have a chat with the doctor about dilators.
thanks for the advice
take care
M

[CLKD]

Hi! mayB have a lookC at the area - it may be split, when the skin becomes thin due to oestrogen loss, that can happen.  If all contact is sore/hurts, then getting appropriate treatment is important.  It may be worth explaining to the GP that if you are prescribed this 'alternative' to VA treatment, if it eases symptoms, would enable you to use others ;-).  If price is indeed an issue.

[CLKD]

Ospemifene - looking at the Ifs and MayBs for this product, it comes with a lot of side effects, non of which I would want.  How does it work taken by mouth  - info isn't clear on this other than it might take up to 3 months B4 any difference is felt.

From NICE :

What are the risks of ospemifene?

Using this medicine may increase your risk for blood clots, strokes, or heart attacks. Your risk for these serious problems is even greater if you have high blood pressure, high cholesterol, or diabetes, or if you are overweight or smoke tobacco. Talk to your doctor about this risk. 1 Feb 2023

Let us know how you get . ??

[CLKD]

I didn't have obvious VA symptoms - having used KY Jelly throughout my Life, swapping to VA treatment wasn't an issue and the latter has helped.

Have U been referred to a dedicated menopause clinic [not a Gyanea], or to a genito-urinary consultant?  Perhaps an exam under a light anaesthetic so that you are totally relaxed may well be the way to go, so that the whole area can be examined slowly without impacting your pain receptors.  Once an area becomes resistant the brain begins the blocking process as a survival tactic. 

R U able to put anything to ease symptoms on the vulva at all?