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Vaginal Renewal™

Download a free PDF version of this brochure

I am a cancer survivor in menopause. I don’t want to use estrogen but I am dry and sex is getting more painful. What can I do?

At A Woman’s Touch, we developed a program (beginning in 1997) for people with vaginas who are  experiencing dryness and discomfort or pain during vaginal penetration that is either diffused throughout the vagina or burning or tearing at the vaginal opening. Although originally developed for people who have had radiation therapy to the pelvis to treat different forms of cancer, people with less aggressive symptoms related to menopause also benefit from the Vaginal Renewal™ program.

We also helped manufacture vibrating wands for use in this program, which you can find by clicking on this link.

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Re-sparking the libido

I’ve entered perimenopause and I’ve noticed that my libido is not what it used to be. Are there things I can do to get it revved up again?

There are natural changes that happen with our libido when our hormonal balance changes at menopause. Libido, or the desire to be sexual, takes practice to happen easily, and it often goes away when you’re distracted by life’s challenges, or your physical health changes.

Fortunately, libido is an elastic state of being that can be invited back into your life. It’s also true that you can enjoy pleasurable sex without having a strong libido. Rosie King, MD writes: “Desire and arousal are two separate components, and are run by different parts of the brain … it is much easier to be turned on if you start with a high level of desire. But even if initially you feel sexually uninterested, if your partner helps to warm you up … you can enjoy a very pleasurable sexual experience … [including] high levels of arousal and orgasm.” (Rosie King, MD, “The Right Conditions for Lovemaking” from “Sex Tips and Tales from Women Who Dare” edited by Jo-Anne Baker)

Where do I start?

To begin nurturing your libido, start with your brain. Start thinking about the good sex you’ve enjoyed. Reflect on your favorite past encounters and fantasies. Allow your body to become aroused, paying attention to the feeling of blood flowing to your genitals. You may not produce lubrication the same way you used to, and that’s perfectly normal. Try to recognize different signs of arousal: swollen labia, a flush on your chest, tension in your nipples, and an increase in breathing. If you have a partner, your partner may notice that your eyes are dilating as well. If you experience dryness of your vulva and vagina, we recommend massaging a moisturizing lubricant into those tissues twice a day. This encourages blood flow to your labia so you become aroused more comfortably.

Don’t stop now.

Allow yourself to think positive sexual thoughts throughout the day, including fantasies, remembering past sexual experiences, and envisioning wonderful sex that you’d like to enjoy. Think about the variety of sexual activities that would be pleasurable, including genital massage, oral sex (on you by a partner) and comfortable penetration of your vagina, if you’re ready for that and enjoy it.

Then, try something a little frisky …

Invite yourself on a sex date. If you did not masturbate before now, you are encouraged to begin. Make self-pleasure a part of your self-care routine. Learn how your body now responds to erotic thoughts, erotic stories and erotic pictures or videos. There is a lot of woman-friendly erotica available to help expand your fantasies and nurture your arousal during both self-pleasuring and partner sex.

Pleasuring yourself will help you know how it feels as your body becomes aroused, and what kinds of touch and sensation feel the best. If you enjoy vaginal penetration, include that in your self-pleasuring, exploring how deeply you like to be penetrated and what width is most comfortable. Begin with one finger, then gently introduce a second when you feel ready. If you can comfortably be penetrated by two fingers, consider using a dildo or vibrator to increase your pleasure. Then, when you choose to have sex with a partner, you can teach your partner what you’ve learned about what works best for you.

But what do I do with my partner until I’m ready for sex?

If you have a partner, make time to enjoy each other in sensual ways. Set aside time for you to give each other massages, enjoying touch and sensation without pressure to have sex. The goal is to get more emotionally connected to your partner. Encourage your partner to masturbate, adding an erotic toy if desired. When you’re ready, start with genital massage using a personal lubricant as your massage lotion (oil can be quite irritating, so avoid oil or Vaseline on the genitals). Eventually, plan to massage each other to orgasm, focusing on the sensations of arousal and orgasm. Then, if you’re interested in intercourse, have your partner massage you until you are quite aroused and ready for penetration.

Keep sex going

It helps to create space for your sex life, without interruptions. Make a date with yourself and/or your partner to enjoy one or two hours of pleasure without answering the phone, dealing with the kids, or thinking about work pressures. If orgasms are important to you, make sure you get the stimulation you need to have at least one orgasm during sex play with your partner.

Slowly building a set of pleasurable, comfortable sexual experiences will encourage your libido to grow. Take time to cuddle afterward, and enjoy the feelings that come from pleasurable sex. The warmth of a positive sexual connection is something you can think about and enjoy when you’re ready for more pleasure.

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Vaginal atrophy, dryness, and lack of flexibility

I am postmenopausal – I have vaginal penetration issues that are severe, tearing and extreme dryness as well as progressive desensitization. I am looking for ways to renew vaginal tissue and increase elasticity. Where do I begin…massage vibrator? moisturizer? kegel exerciser? estriol creams?

Begin with reading through the Vaginal Renewal program.

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Vulvodynia and Vulvar Pain

Why is my vulva so sensitive? I’ve been told I may have vulvodynia. What is vulvodynia? What can be done to treat it?

There are many potential causes for pain in the vulvar region, and the term “vulvodynia” is a word that describes a variety of conditions. Vulvodyina, or chronic vulvar discomfort, is characterized by burning, stinging, irritation or rawness of the vulva. Three different sub-types have been described, and have different treatment approaches:

  1. skin disease,
  2. inflammation of the vulvar opening, and
  3. irritation of the nerves that serve the vulva.

Vulvodynia is a diagnosis made after other diagnoses, such as vaginal infections, neuropathies, sexually transmitted infections, and other dermatological conditions are tested for and found not to be the cause. If you have an actual sore or scab patch on your vulva, you very likely need a series of biopsies to diagnose the problem. (One biopsy isn’t enough: it usually takes three biopsies minimum to determine a diagnosis.) Even when health care providers have extensive genital dermatological experience, the good providers will get a biopsy to confirm the diagnosis.

For skin-related vulvodynia, steroid ointments are used, often successfully, for treatment. (NOTE: Steroid creams, by definition, have alcohol in them, and should be avoided.) Although it is true that we need to be careful of using steroid ointments on the skin of the body (because it causes thinning), the vulva is relatively steroid insensitive, and use of steroids on the vulva does not cause the same problems that it can elsewhere.

Having said that, one should only use the very smallest amount prescribed, and ONLY on the areas where directed. Using more doesn’t make something better, and can cause it’s own problem if you become irritated by the base that the medication is in. Also, make sure to completely avoid the anal area unless your health care provider has instructed you to use the steroid there. The anus is very SENSITIVE to steroid ointments, and thinning can cause fissures and other skin problems you don’t need to add.

For women who experience inflammation of the vulvar opening, good attention to vaginal health may help. The skin at the opening of the vagina is just more sensitive than that of the lips, and often needs some healthy conditioning to help vaginal penetration be more comfortable. Look at the AWT Vaginal Renewal posts, and consider whether that may work for you.

We also find that strict attention to a low inflammation diet (see the AWT Good Sex Diet) helps dramatically with many types of skin inflammation disorders. Some women find relief with alpha-interferon injections, and others choose to pursue a surgical operation (vaginal advancement) when vestibular glands are infected or impacted for a long period of time.

The most severe cases of vulvodynia are those with neurologic irritation. Pain occurs wherever the nerves in the region receive too much sensation: the clitoris, vestibule (vaginal opening), urethra, perineum (skin between the vaginal and anal openings), and down the inner thighs. As in other cases of sensory neuropathies (diseases of the nerves), antidepressants and anticonvulsants may ease the pain in some cases by “resting the nerve” and allowing it to heal.

Other people may need an evaulation by a pelvic floor Physical Therapist, to determine whether a muscle spasm is causing compression on a nerve that you then feel as pain.

Vulvodynia can be a difficult condition. For many of the conditions, the cause is unknown, and the cure elusive. For some women, it’s a big breakthrough to know the name of this condition, and that this is not something “in their head”, or something to be ignored.

For more information, visit the website vulvodyniasupport or contact the National Vulvodynia Association (online at and ask for a referral for a gynecologist or genital dermatologist in your area who is familiar with vulvodynia.

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Vaginal Renewal after Cancer or Surgery

I have completed radiotherapy for cervical cancer, but I’ve noticed that my vaginal space isn’t as big or as flexible as it used to be. Is there anything I can do to help recover my previous abilities?

First, I’d like to address the health part of your question. This part of your body has been through a lot, and needs some recuperative attention. This first information really doesn’t have as much to do with “having sex”, as it does with helping your body heal again.

Healing Step Number Two

Healing step Number One, of course, was that you had treatment for a serious medical threat. Congratulations! Now that you’ve been through the radiation, your body will naturally scar some to try to heal the damage that was inadvertently done while the radiation was zapping those cancer cells. One way to help to soften the scar tissue (inside and outside) is to massage your skin with a moisturizing lubricant of your choice.

The way to do the massage is to make a plan for yourself. I often suggest that you put the bottle of moisturizer by your toothbrush, so that when you brush your teeth morning and night, you also do your massage morning and night. A reminder: this doesn’t mean that you are “ready, honey!” for sex. If you need to lock your bathroom door, by all means do. This is really a self-care issue.

Put a dime-quarter size dab of lubricant on your fingertips, and massage your entire vulva (the outside of your vaginal area), your clitoris, the vulvar lips … by using a press-and-release technique, not a friction massage. Your goal is to bring new blood to your skin with these strokes, and to push old blood and fluid out of the skin. You are not trying to stretch your skin; rather, you are trying to increase your skin’s flexibility. You don’t need to feel “wet” when you are done, but do use enough lubricant that your massage feels somewhat slick, so that you know that you are using enough to moisturize.

If you feel comfortable, go ahead and massage the lubricant into the opening of the vaginal canal, using these same circular strokes. Most women find that they can accomplish this in about five minutes, so you don’t need to feel that you’ll be spending the rest of your life doing this. I usually suggest that women who are at your stage of recovery do this massage for about two weeks before progressing to the next step.

If you forget an evening, or go away for a weekend – don’t worry about it. Your teeth don’t fall out if you don’t brush your teeth once, and your vulva isn’t going to fall off if you forget to do this massage. Just get back to your routine when you are ready or able to do so.

Healing Step Number Three

The next step is to use a smooth-surfaced vibrator (something that can be inserted into the vagina) to help slowly and comfortably massage your inner vaginal skin, and help you massage lubricant far up into your vagina. We recommend using one of the Vaginal Renewal Massage Wands for this part of the process. You can start by just coating the wand with lubricant and inserting it as far as is comfortable. If you’ve had radiation, you may be instructed to push it firmly as far as it can go, so that you break up the developing scar tissue before it gets too thick. You can then turn on the vibrator to a vibration level that feels comfortable, and let it run in place for 5 – 10 minutes.

You’ll want to find out what size will work best for you at this point in your recovery. The best way to tell which size to get is to see how many fingers you’re comfortable being penetrated with when you’re not sexually aroused. Once you know this, you can get a wand that is approximately the same width across as your finger(s). Start with one that is right for you now, rather than something you want to “work up to.” To know when you’re ready to move to a wider wand, you will want to try gently inserting a lubricated finger alongside of the wand. If you can do so comfortably, you’re ready for the next size.

Again, the goal here is to bring blood to the area; to exchange blood/lymph fluid; and to increase the flexibility of your skin. (It isn’t that you’re “too tight” – we don’t want flabby vulva lips here! It’s that we are trying for increased flexibility so that your skin can adjust to penetration if you so choose.)

Healing Step Number Four

The next step is to evaluate yourself with regard to your orgasmic potential. Are you able to bring yourself to orgasm currently? (Could you before, or could you ever?) This is important, because I think the radiation may also have an effect on your blood vessels, which can make orgasm more difficult. If you are able to bring yourself to orgasm, you have my prescription to bring yourself to orgasm at least once a week (for the rest of your life). This is really preventive maintenance of your body. If you are not able to orgasm now, or have never been able to orgasm, check out one of our articles on this site about how to learn to orgasm, or pick up a good book on the subject. If you haven’t tried to orgasm since all of this radiation stuff, please attend to your “homework” and find out if you can still have orgasms.

It’s important to continue to have sexual pleasure, because I have met and spoken with many women who say that the *first* thing they thought of was life/death and surviving, and that they de-prioritized this “sexual pleasure” part. Then, as the years roll by, some of that scarring has already occurred, and it’s difficult for some women to experience orgasmic release. It seems to be an easier road to maintain the system/process than to recover it (although recovery is possible too).

From Here?

The road going forward depends on the process, rather than an endpoint. The path you travel from here may take you to continued daily massages, with intermittent orgasms; or you may find that you can take vacations from the massage/orgasm schedule, and restart the program when you need to. Listen to what your body needs, first and foremost.