When it comes to women's health, there is no such thing as a silly question. Do you have a question you want answered, but have been too afraid or embarrassed to bring it up with your GP? Or you forgot to ask while you were in the doctor's surgery? Now, you can 'Ask Dr Jean'.
Answering your questions for this edition of 'Ask Dr Jean' is gynaecologist and Jean Hailes Medical Director, Dr Elizabeth Farrell AM (pictured).
I am 65, have been married 45 years and have always enjoyed having sex. About 8 years ago I found having intercourse was becoming painful, and now I cannot have any penetration. It is not a lubricant issue, and even before a Pap smear my doctor prescribes me some cream for a few weeks, but it is still extremely painful. What could be causing this?
After the menopause, because of the loss of oestrogen, the tissues of the vagina and the vaginal entrance become thinner, drier and less elastic. The loss of elasticity can sometimes reduce the size of the vaginal entrance, making penetration painful or impossible. Secondary to the pain, women automatically tense their pelvic floor muscles without consciously being aware of doing it. This leads to the muscles becoming tense and tender, and another cause of pain during sex.
Vaginal oestrogen products help to make the skin thicker, more lubricated and may also help the elasticity. An assessment by a women's health GP will help direct you to the right health professionals and treatments (such as a pelvic floor physiotherapist to teach you pelvic floor relaxation techniques).