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Sometime around age 46, sex started to hurt Stacey Tompkins. Badly.
“It felt like someone had mixed and inserted a thick paste of sand and salt water up there,” says the Bozeman, Montana-based hypnotherapist and certified integral relationship coach. Perimenopause had turned sex from slippery and fun to abrasive, stinging and friction-y, and by the time she hit the big M two years ago, at age 50, her vaginal lining had thinned enough that not even gobs of lube were enough to hydrate her Sahara situation.
About half of women experience menopause-related vaginal dryness, a.k.a “sandpaper sex,” says
Lauren Streicher, MD, medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause in Chicago and author of Sex Rx: Hormones, Health and Your Best Sex Ever.
But unless you’re having a killer orgasm, there’s no reason to scream your way through sex. You have options.
Lube up
Lubricants can help by providing a slippery coating that reduces friction. For many women, this does the trick.
The problem, Streicher notes, is that "all lubricants are not created equal.”
First, a quick biology lesson: Remember learning about osmosis in high school? It’s the process by which water moves back and forth across a cell membrane in an effort to maintain balance. Many popular water-based lubes have a high osmolality, or concentration, compared to that of the vag, so when you shmear them on, the vaginal tissue, which has a much lower osmolality, responds by releasing moisture in an effort to dilute the lube. The result: You end up drier than before. Water-based lubes also contain preservatives, which can be irritating.
For that reason, Streicher recommends silicone-based lubes; not only do they tend to be preservative-free, but because they don’t contain water, osmolality is not a concern. (She recommends
Aloe-ahh Personal Lubricant.) Silicone lubes also tend to feel more slippery and less sticky than water-based, she says. Another brand to check out:
Replens Silky Smooth.
Amp up your lube with some heat. Warmth increases blood flow, a good weapon in the fight against sandpaper sex. Warming lubricants often contain irritating ingredients derived from red peppers or menthol, but you can warm up a nonirritating lube you love with a product like the
TOUCH automated dispenser for warmed lubricants and oils. It resembles a smaller version of one of those high-tech Dyson fans and heats up the lube with the touch of a button. When you’re ready, just wave your hand underneath and, like an automatic soap dispenser, the perfect, warm squirt comes out. It takes a few minutes to warm up, which is a bonus for you because that basically guarantees extra foreplay time.
Mo' moisture, fewer problems
Long-acting moisturizes are different from lubes, in that the latter are used when you’re about to do the actual deed; the former are used prophylactically, multiple times a week, to boost water content inside the cells lining the vagina. These products, which are inserted in the vagina with an applicator, “result in tissue that is more elastic, thicker, and better able to naturally produce [vaginal] lubrication,” Streicher says. She tells patients to start with a product like
Replens Long-Lasting Feminine Moisturizer twice a week, possibly progressing to three or four times a week. Other brands to check out: Another brand to check out:
Hyalo Gyn.
Local vaginal estrogen
Available via prescription, these products are placed in the vagina on an ongoing basis to improve the thickness, lubrication and elasticity of vaginal tissue. The amount of estrogen that gets absorbed into the bloodstream is minimal, Streicher says, making it safe for everyone. Estrogen creams and vaginal tablets are usually used twice weekly; there’s also a disposable ring that needs to be replaced every three months.
It's worth noting that other potential sandpaper sex culprits include breastfeeding (estrogen levels plummet); certain drugs, including oral contraceptives, antidepressants, and select cold or allergy meds; and vulvodynia, a chronic pain condition. Never be shy about telling your doc about painful sex…she wants you to enjoy it.
It also helps to have a patient, supportive partner. Tompkins says she and her hubs are back to happy, pain-free sex. “He did some research and discovered a brand of silicone lube called Penchant Premium,” she says. “Now we have a few cases in storage.”
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