HRT no quick fix for painful postmenopausal sex
Reported August 08, 2008
It’s a common complaint of some postmenopausal women – painful sexual intercourse. The condition is medically known as dyspareunia and it’s no fun at all.
Doctors often attribute the problem to declining estrogen levels, which can lead to changes in the genital tract, including vaginal atrophy. The usual treatment is hormone replacement therapy, which can be applied directly to the sensitive region or taken in pill form.
But McGill University researchers have found that a significant number of women – up to 20 per cent – don’t respond to hormone therapy and they are seldom offered other treatments.
“Pain during intercourse can affect your relations with your partner, your image as a woman, your mood, all sorts of things,” said Irv Binik, director of the sex and couple therapy service at McGill University Health Centre in Montreal.
He said it is a mistake for doctors to assume all cases of painful intercourse after menopause are linked to the reduction in female hormone levels that occur with normal aging.
“It just isn’t that simple for a lot of women,” said Dr. Binik, senior author of the study that will be published in the journal Pain Research and Management.
Lots of other factors, including problems with pelvic floor muscles, dermatological conditions and infections, can make sex an unpleasant experience, according to Alina Kao, a PhD student who led the research project.
That also means there are a variety of different treatments – from physical therapy to traditional pain management – depending on the underlying cause.
However, Dr. Binik cautioned that these options are not usually quick fixes. “All of them take time and effort,” he said. “It’s not like popping a pill or putting on a cream.”