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?


You want to begin with reading through the Vaginal Renewal program that we have put together.

For women with severe dryness, we recommend daily moisturizing using either Sutil Luxe Lubricant (with hyaluronic acid) or a hybrid lubricant such as Sliquid Organics Silk, Sensuva Hybrid or Oasis Silk. If you find that none of these work for you, then we recommend trying the Slippery Stuff lubricant as a low irritation choice.

Something that helps many people is internal vaginal massage with a vibrator. Choose the size of the vibrator by deciding how many well-lubricated fingers you can comfortably insert into your vagina when you are not aroused. Then measure that width – this is the width of the vibrator you want. Many women who experience severe dryness and inelasticity have to start with the Massage Wand Size 1, which is the slimmest vibrator of its kind available. As your skin becomes more flexible and develops more of a cushion, you can increase the width of the vibrator you are using until you work up to the widest size listed next to the article. If your partner is wider than that, we can help you choose the next one.

In addition to following the Vaginal Renewal program, you will want to do Kegel exercises daily, following the instructions in our Pelvic Floor Health for Women brochure.

You don’t have to use a tool, but if you have trouble locating your pelvic floor muscles, a tool helps you find them and be sure that you are exercising the correct muscles correctly.

These exercises will help to increase the flexibility of your pelvic floor muscle, and learning how to do the full, deep relaxation of that muscle at the end of each exercise will help you relax the pelvic floor when you are ready to enjoy penetration again.

You also want to try to have one orgasm a week, either on your own, or with the help of a partner (but no intercourse for the first month – so partner play should be focused on oral or manual stimulation). If you are having trouble with sensitivity, using a vibrator for external stimulation can be helpful. This will also increase blood flow to the tissues, encourage regular firing of the nerves that respond to sexual stimulation, and exercise your pelvic floor. If the vibrator you have for vaginal massage isn’t strong enough, get one that is stronger.

Estrogen cream can speed up the recovery of your skin, but is not necessary. If you want to use it, then go ahead and get a prescription from your doctor. You can stop using it later if you wish. If you are a cancer survivor, then talk with your oncologist before using any estrogen product.

As for change in sensitivity…the massage, orgasms, and pelvic floor exercise will help. The other things that will help are to exercise your body every day for at least 30 minutes, vigorously enough to sweat, and follow a “good sex diet” that increases blood flow and sensitivity.

All of this begins the path towards helping you to a place where penetration is more comfortable and orgasms and arousal happen more easily.