Painful Intercourse Can Have Numerous Causes

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“Dear Pharmacist,

Sexual intercourse has become very painful since stopping
HRT (Hormone Replacement Therapy). I’ve tried progesterone
and Vagifem, but nothing helps. I think this is a concern
for many women. Do you have any other suggestions?”

–E.K., Ocala, Florida

ANSWER: Indeed, many women have this problem, especially
older ones who experience vaginal dryness while going through
menopause. Some women also take certain medications that lead
to vaginal dryness, including antihistamines used for allergies,
tricyclic antidepressants and, believe it or not, birth control pills.
Younger women who still have a menstrual cycle may experience
painful intercourse due to endometriosis, a condition that usually
includes severe cramping and back pain during menstruation, painful
bowel movements, fatigue, spotting and difficulty conceiving.
The quick fix for vaginal dryness is a lubricant, easily found
at any major retailer, health food store, or pharmacy. Brand names
include AstroGlide, K-Y, LifeStyles, Replens, Zestra and Vibrel.

That last one utilizes niacin, a B-vitamin and it is a topical lubricant.
Some of these inexpensive products are ‘warming,’ while
others are ‘cooling’; these effects are intended to heighten sensation
and reduce friction. Personal lubricants only work temporarily and
won’t help every couple because painful sex may have nothing to do
with vaginal dryness. That’s why doctors may need to get involved
for a proper diagnosis.

I always suggest taking oral vitamin E, about 400-800 IU
daily, which also nourishes hair and skin.

In addition, omega 3 fish oils (1,000 mg once or twice daily)
are important for the same lubricating reasons. Another consideration
is your hormones.

Ask your OB/GYN if you have lower levels of thyroid,
estrogen or testosterone — three hormonal issues that could also
lead to vaginal dryness. One popular test kit retailer who sells
hormone test kits is There is more about this
lab test, and other hormone test kits in chapter 16, read Case #3.

Getting your hormones balanced is really important, and I
can’t stress this enough. Speaking of stress, if your life is riddled
with hassles and obligations, dominated by a never-ending ‘To Do’
list (welcome to Earth!), consider Panax ginseng. This oriental herb
supports adrenal function so you can cope, but it also helps men and
women boost sex drive and reduce painful sex (because it thickens
vaginal mucosa). Panax ginseng is a terrific option and is considered
very safe, but it doesn’t work overnight. Be compliant — dosages
vary, but 200 – 400 mg once or twice daily is a common dose. It’s
fine to take with vitamin E and fish oils, too.

Did You Know?
Calcium D-glucarate rids your body of cancer-causing
estrogen before it lodges in your tissue.
Dosage: 500 – 1,000 mg two or three times daily.