I am a 59-year old, post-menopausal woman. After being sexually inactive for many years, I have recently started a relationship which is very physical. Every time I have sex, I get thrush together with the terrible burning and itching that goes with it. I am almost permanently on Fluzol. My gynae presecribed topical oestrogen cream - first Vagifem and then Premarin - which definitely helped with the lubrication, etc. Unfortunately, they both give me the most terrible migraines and I have had to stop using them, much to my disappointment. Help! I don't know what to do. This is ruining my sex-life! I am trying Replens but I have a feeling that in the long run this is not going to solve the problem. How often should I use it and is there anything else I can do?

Dr. Eve Answers:

Your letter is so typical - as women age they buy into the myth of being asexual so go into sexual neglect until boom bang along comes a prince (often times a princess!) and find their ageing vaginas surprisingly need attention, are a whole lot more complicated than the last time it was used:)

You are being really well managed- congratulations to your health care provider. What has happened is that the loss of estrogen has translated into a very thinned out depleted epithilium, which is the lining of the vagina. This lining is essential for protecting the vagina, cervix during penetration- it acts like a cushion and protects the urethra as well. hence your bladder infections- there is no longer protection against thrusting.

I am so sorry that the local vaginal estrogen supplements have bad side effects for you- they are ideal to build up the epithelium. I agree that Replens is next way to go. Replens is a "mositurizer" so it will get rid of dead vaginal cells and mositurize the epithilium giving it some  new cell build up and cushioning effect. it is healthy  and safe to use 3x a week - forever.

Have you tried /considered Premarin local vaginal supplement?It has a low quantity of estrogen in it but may be more  beneficial  than the Replens as it contains some estrogen. Please check in wiht your health care provider about this possibility.

I urge you to use a lubricant in addition to your mositurizer: water or silicone based lube is great for entry of vagina, an on the penis- really makes a smooth insertion possible. I recommend PJUR or the new Good Clean Love we just imported , an organic natural product.

Do not give up sex- keep replenishing your vagina.