Guest blog by Lauren Streicher, MD
Author of Love Sex Again: A Gynecologist Finally Fixes the Issues That Are Sabotaging Your Sex Life
You’ve, no doubt, heard the term “erectile dysfunction” or “ED.” But what you may not realize is that this term was popularized as part of a marketing campaign—not by doctors.
Prior to 1998, men who were unable to maintain an erection suffered from “impotency,” a diagnosis that implies weakness and powerlessness. A guy who was impotent didn’t just have a medical problem; he was also a personal failure. And no way was he going to make an appointment to discuss his impotency with his medical doctor. Suddenly, in 1998, the impotent man disappeared, and the man with ED emerged. This man was handsome, successful and sexy.
So who spread this new, mighty term? It was the people who had the most to gain from men admitting they had a problem: the inventors of Viagra. Pfizer launched Viagra and at the same time launched a genius marketing campaign that redefined impotency as erectile dysfunction. The condition was not only normalized, but it gave men the language to talk to their doctors about it so they could comfortably ask for a prescription.
And for every man who suffers from erectile dysfunction, there is a woman who suffers from vaginal atrophy. Women with vaginal atrophy as a result of hormonal changes that occur during the transition to menopause have vaginal walls that are so thin and dry that intercourse is either excruciating painful, or impossible. The condition is just as common as erectile dysfunction. But no one is talking about it, and most women are not getting treated for it even though there are many excellent options to alleviate the problem.
But, like men who are impotent, no women (even if they are familiar with the term) wants to have vaginal atrophy! But for the 50 million women who have vaginal atrophy and have lost the ability to have pleasurable, slippery sex, I have a solution. My version of ED for the women.
Instead of having the use the term “vaginal atrophy” (which no one knows, can remember, or wants to say). I would like to introduce a new term to describe the changes that occur not only around the time of menopause, but from a number of medical conditions as well.
GD stands for “genital dryness.” Your doctor will not know the term GD, (not yet, anyway), but they will understand what you mean when you say you have “genital dryness” and you need a solution.
Thin dry vaginal and vulvar tissues affects 40% of postmenopausal women. But it’s not just midlife or older women that suffer from this problem. There are a number of other circumstances that can reduce natural lubrication in any age woman such as post partum and nursing mothers, hormonal contraception, women being treated for cancer with chemotherapy or radiation and medications such as anti-histamines, decongestants or tamoxifene.
The guys have it a little easier since most ED can be solved with a pill. GD isn’t always so straightforward, but you do have options:
1. Lubrication is key. The right vaginal lubricant is an essential ingredient for turning “sandpaper sex” into slippery sex. Most drug stores have a dizzying selection of lubricants, but almost all are water based. While readily available and inexpensive, most water-based lubricants are gloppy, sticky and contain a propylene glycol preservative, which can be irritating. Silicone lubricants, on the other hand, are more slippery, last much longer and are non-irritating.
2. Moisturizers are not just for your face. A lubricant is to be used at the time of intercourse to reduce friction. Lubricants do not alter vaginal tissues; they just make them more slippery. A long acting moisturizer, on the other hand, is intended to change the water content of the tissue (hence “moisturizer”) resulting in tissues that are more elastic, thicker, and with enhanced ability to produce fluid, that will in turn reduce friction.
3. Estrogen is not the enemy. It would be nice if lubricants or moisturizers always solved the problem, but sometimes the ravages of menopause make the vaginal walls so thin and dry, that the only way to reverse the vaginal clock and make intercourse comfortable is estrogen. I know…estrogen. Everyone thinks breast cancer, blood clots, bad stuff. Keep in mind that the FDA required warnings and complications listed on the package insert have never been shown to occur as a result of using a local vaginal estrogen product. All vaginal estrogen products improve the thickness, elasticity and lubrication of your tissue. Personal preference, ease of use and convenience (not to mention what your insurance covers) dictate which product you choose. Currently, there are three types of prescription vaginal estrogen products: creams, a vaginal tablet, and a vaginal ring.
Every woman should come up with an individual plan with the help of her doctor. But, most important is that women take a page from the man with ED’s playbook and stop being ashamed.