Are you experiencing painful sex after menopause and don’t know how to talk about it even to your doctor? You’re not alone! Thousands of women suffer in silence because they’re embarrassed to discuss vaginal atrophy. Thank you for joining us for another segment on 2nd Act TV, real happy that Dr. James Simon stayed over with us for a you know, a segment that is really difficult for some women a topic for women to discuss I know I was one of them I want to treat this segment both from the clinical perspective but also talking to you as a man talking to a woman because this is a big issue as a woman I know I was in that situation where I wouldn’t want to bring this up, there’s something wrong with me or maybe my my partner my husband you know thought I didn’t desire him you know do you hear this from women will they talk to you about that openly? Generally they will in my office but that’s because I prompt them and I have a very easygoing style if you will that kind of drags it out of them but I think your comment is very apropos most women are embarrassed about it they think it’s a natural thing to go through menopause and this is just part of natural aging maybe their mother had pain with sex and they were told that you just have to deal with it and whatever but with the way I take care of that is to be proactive in fact I asked every woman whether she’s 20 or 80, a) if she’s sexually active and b) does she have any questions about sex is she having any pain etc and if you’ve been a patient of mine for a while you’ve had that every year for a while and you know when you get to be 50 or 51 or 52 it’s no big surprise because last year and the year before you have the same question it’s true the more you talk about it the more normal it gets, that’s one thing that I’ve learned you know having produced this show for the last few years what I’m talking about openly right now that I would never talk about in private is it surprises me and you know it it does spawn conversation with other women but what are you know what are the best fixes for it because it can make and I know that hormone replacement made a huge difference with me, how do you go about treating it? so first is to get it out in the open and to tell women that it’s natural that she have some decrease in her normal secretions that is to say that her vagina may feel dry especially dry when she’s having sex but always what I call walking around dryness the other is to explain to her that pain with sex will ultimately occur to her unless she is proactive about taking measures into her own hands and most of the women who actually come with the complaint as opposed to my initiating the conversation they’ve already tried over-the-counter lubricants or moisturizers and those are not the same or some other treatments to help their vaginas become more soft and supple and the way they were when they were younger. For somebody that’s watching the program right now and their going oh my gosh that’s me so what what should I do with my first step what would you say? So I think the first step is to understand that what we’re talking about is normal that doesn’t mean you want it but it’s normal you didn’t do anything bad to bring it on it’s part of normal aging and it gets slowly and progressively worse. Then is the best way to fix it to go to your ob/gyn talk about it openly so there’s no one best way I would say that we have a number of options for women you mentioned systemic hormone therapy and that is an option so a woman whose taking medication for hot flashes or disturbed sleep or night sweats that medication usually also treats her dryness and atrophy of her vagina about ten to fifteen percent of women who are on perfectly adequate systemic hormone therapy still need something vaginally something specific for their vaginal dryness or pain with sex now most women who are not using hormone therapy for hot flashes for example they will start to have symptoms or dryness with sex that’s not adequately treated with the over-the-counter lubricant or moisturizer about age 55 not right at menopause but a little later and it’s going to sneak up on her so she’s having sex it’s normal, they use a little lubricant everything is fine and then one day oh my goodness it really hurt she didn’t tell her husband or partner and she thinks the next time it’s going to be better and it’s not and it’s getting worse ectcetera that person is likely to need a medical treatment for her vaginal atrophy and pain and they come in a variety of different forms both local estrogen treatments that have been available in the US for more than 60 years or there are now some oral not estrogen treatment that also treat dryness and pain with sex and and these are all available and your obstetrician gynecologist should know about them or be able to give you good advice on them. The message though is that don’t be embarrassed about it and talk to you a doctor and if any physicians are watching this, prompt the women because we are embarrassed we did or we can be but that is this is something you know taking charge of our sexual health is if we do it we can have wonderful sustainable sex life for a lot of years to come right? Absolutely don’t be embarrassed it’s a body part it’s like the nose on your face if your nose if you had pain in your nose you’d bring it up. it’s just a body part even though it’s a sexual body part and if it’s not working right or you’re having pain you should bring it up to your practitioner even general family docs should be well-versed in how to take care of this and if not seek an expert either an obstetrician/gynecologist or specialist in menopausal medicine. Thank you Dr. Simon, very much. I’m going to hold you over for one more segment so we can discuss getting our desire back once we’ve lost it and what some of the reasons for that are, so see you on another segment! Thanks so much for watching! Right here’s another video I think you might enjoy and while you’re at it, please subscribe to our channel, button’s right here! Thanks, see you next time.