Sexuality, sexual intimacy and sexual health in later life
V. Minichiello, I. Coulson in Contemporary Issues in Gerontology, 2012
Coping with physiological changes can be distressing, but medical technology can assist. The use of lubricants and hormone replacement therapy can reduce vaginal dryness. A range of interventions for altered erectile function is also available and includes hormone treatment, vacuum devices, implants and surgery (Schiavi 1999). One of the drug treatments for impotence is widely known as Viagra. Launched onto the global market in 1998, it became the biggest selling drug in the world within two weeks (Tucak 2002). Treatment is in the form of a tablet, which works by dilating blood vessels in the penis, thus increasing blood supply and facilitating erection. The tablet must be taken at least 30 minutes prior to sexual activity and the effects can last up to four hours (Pfizer 2002). Perhaps one of the reasons men have embraced the use of Viagra with such enthusiasm is its ease of administration. Other drugs available on the market such as Caverject require a direct injection into the penis that can be difficult and painful to administer. A tablet is simple to take and no one need know, thus maintaining privacy and self-esteem.
Gynaecology: Answers
Euan Kevelighan, Jeremy Gasson, Makiya Ashraf in Get Through MRCOG Part 2: Short Answer Questions, 2020
Late radiotherapy damage can occur months or even years after treatment. Bowel effects include acute or subacute obstruction, bleeding, perforation, fistula formation and malabsorption (1). The bladder may be affected long term due to contracture formation, with associated reduction in bladder capacity. Haemorrhagic cystitis may occur, causing haematuria and pain. Fistula formation can occur, especially with the vagina and ureteric obstruction, and hydronephrosis has been described (2). In premenopausal women pelvic irradiation can cause subsequent ovarian failure and premature menopause (1). Vaginal effects include atrophy, causing shortening and stenosis. Vaginal dryness can occur, which may lead to sexual problems (1).
Sexual Health
Carolyn Torkelson, Catherine Marienau in Beyond Menopause, 2023
If you experience chronic vaginal dryness, despite the use of moisturizers and lubrication, you will likely need to use a low dose of vaginal estrogen therapy long term to continue having vaginal intercourse. Vaginal dryness, unlike hot flashes, does not go away over time. You need to keep those estrogen receptors in the vagina happy with a regular dose of estrogen. Another important factor is the use-it-or-lose-it phenomenon: regular sex, either with a partner, through masturbation, or a combination of the two, definitely helps keep vaginal tissues more supple and moist.
Rationale and design for fractional microablative CO2 laser versus photothermal non-ablative erbium:YAG laser for the management of genitourinary syndrome of menopause: a non-inferiority, single-blind randomized controlled trial
Published in Climacteric, 2019
R. Flint, L. Cardozo, T. Grigoriadis, A. Rantell, E. Pitsouni, S. Athanasiou
Genitourinary syndrome of menopause (GSM) is the new terminology for ‘vulvovaginal atrophy (VVA)’1. The GSM definition was introduced to describe more accurately the urogenital changes and the local symptoms occurring after the menopause in comparison to the terms of VVA vaginitis1. Hence, it involves clinical symptoms and signs from both the genital tract and the lower urinary tract (LUTS)1. Although women may present with some or all of the clinical symptoms and signs1, the most common symptom of VVA/GSM is vaginal dryness2–4. Vaginal dryness occurs at or soon after the menopause, with a subsequent increase in prevalence as the postmenopausal years progress3, and is associated with an increase of LUTS5. GSM is chronic in nature and may worsen over time, jeopardizing sexual function and quality of life in up to 50% of postmenopausal women6–10. In breast cancer survivors, GSM can affect up to 70% of the postmenopausal patients when compared to postmenopausal women without breast cancer11,12.
Vaginal lubricants and moisturizers: a review into use, efficacy, and safety
Published in Climacteric, 2021
The rate of reporting symptoms to health-care professionals by women is typically low and thus vaginal dryness goes under-treated2,17,18. Only a minority of women actually seek help17 for many reasons, including embarrassment, perceptions of triviality, the misunderstanding of having to tolerate these symptoms as normal aging, a lack of awareness, inconvenience of obtaining products, or potential messiness of use. All of these may be the reasons behind and barriers to seeking and using treatment. Health-care professionals are less likely to ask about vaginal dryness than other symptoms, possibly because they are uncomfortable discussing sexual issues. There is also a lack of knowledge about current available treatments. Products are over-the-counter preparations, so health-care professionals have less awareness and exposure to them as they rarely prescribe them. Atrophic symptoms usually progress with time and require treatment that is maintained for continued relief. Thus, over the years, the impact is cumulative, either positively with the correct treatment, or negatively with no treatment or the wrong treatment.
Managing menopausal symptoms after cancer
Published in Climacteric, 2019
R. A. Szabo, J. L. Marino, M. Hickey
Lubricants and moisturizers. Despite being widely recommended for vaginal dryness, there is little evidence to support the effectiveness of vaginal moisturizers and lubricants59. The intended benefit of vaginal lubricants is to reduce friction during sexual activity, and so reduce discomfort and pain. Common lubricant bases include water, mineral oils, plant oils, and polymerized siloxanes (i.e. silicone-based lubricants). In practice, oil-based lubricants cannot be used with latex condoms, and both oil-based and silicone-based products dry more slowly than water-based products, and thus persist longer during sexual activity60. Glycols (e.g. glycerin and propylene glycol) may be added to water-based lubricants to slow drying, but this may actually worsen symptoms as they increase osmolality and the risk of epithelial disruption59, which may cause microtears and pain.
Related Knowledge Centers
- Vagina
- Ovulation
- Sexual Arousal
- Sexual Intercourse
- Blood Plasma
- Bartholin'S Gland
- Mucus
- Cervix
- Sexually Transmitted Infection
- Ph