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Ask Dr. D. Love Your Own Question

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 17527
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Dont know if you can help three years i have been

Customer Question

Hi dont know if you can help for the three years i have been finding sex very paifull i am a 58 year old women ive had three children two births were assisted with a cut from the bottom of my vagina to my anus and this seems to be wear the pain is it some times feels like im cut there i ubderstand that because aged 52 i had an opertion twice re my bladder also i went into my change at 39.
ive been given lub and numbing cream which makes things a little easier but hrt does not seem the answere can you please help im now very tired and fed up with this on going problem.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. D. Love replied 10 months ago.
Hello from JustAnswer.
I am sorry that you are having so many difficulties.
There are several options when managing pain during intercourse.
The most commonly used interventions in someone with the symptoms that you describe is the use of lubrication with or without numbing medicines, such as lidocaine gel, and your doctor has already tried this.
If the pain is due to atrophy of the vaginal lining, hormone replacement therapy is an option, but there are many long term risks associated with estrogen replacement. There is a newer drug, ospemifene, that is designed for post-menopausal pain with intercourse. This drug works on the estrogen system, but does not appear to have the same risk relative to the breast and uterus regarding cancer risk. Since it is a new drug, it is one of the last drugs considered, but is an option if no other intervention is effective.
There also is evidence that certain behavioral interventions, such as biofeedback or focused relaxation, can help with pain with intercourse.
For a woman with chronic pain related to prior surgery or trauma, it also may help to use a medicine that helps with chronic pain by suppressing the nerves that carry the pain message. These medicines are mostly used for chronic musculoskeletal pain, but may help with pain with intercourse. The most commonly used drugs are certain anticonvulsants, such as gabapentin or pregabalin, and certain antidepressants, such as amitriptyline or duloxetine.
If I can provide any additional information, please let me know.
Expert:  Dr. D. Love replied 10 months ago.
Please let me know if I can provide any further assistance.
If you would like my assistance with any future questions, I can be reached through my profile at www.justanswer.com/medical/expert-DrDLove/

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