A 52 year old woman going to the doctor and telling them sex hurts and the doctors not immediately talking about menopause is like a 12 year old girl going to the doctor and telling them she's bleeding from her vagina and the doctor not immediately talking about menstruation. "Let's run some tests." It's mind boggling how ignorant some doctors are.
I started having pain with sex around the same age. I saw a women’s health specialist (usually gyn not ob). Even though I still had irregular periods, blood work showed I was in menopause. HRT pellets changed everything for me. I now have my libido back as well as pleasure with sexual activity. Don’t stop trying to find your solution. Sex should continue to be a natural and pleasurable experience for you even as we age. Good luck!
I was lucky that just before menopause I saw a hormone specialist NP and she gave me HRT and vaginal estrogen and manually separated my clitoral hood adhesions — which I didn’t even know was a thing. She told me I already had significant atrophy, but vaginal estrogen might reverse it. (My poor bestie has had two surgeries for painful clitoral adhesions.) Not to scare OP further, but low estrogen can cause your external clit to atrophy entirely. Look it up, it’s terrifying and it’s happened to many older ladies who were denied proper HRT due to unfounded fears of cancer.
Absolutely. Mine just disappeared. It was really freaky. (I felt like a certain scene in Handmaid's Tale, it was horrifying)
Thank goodness for hormones
What you need is vagina estrogen, either cream or pessary/pill. Depending on how advanced the vaginal atrophy is, you might need dilators, but it's not common. This is definitely a symptom of perimenopause, so you can't really say that you don't have any symptoms. Doctors sadly aren't always knowledgeable about perimenopause and you'll have to advocate for yourself.
HRT will be your friend. Before I started HRT it felt like I was being stabbed during intercourse (I know, sounds harsh). Also Grapeseed oil is a good lubricant.
I can’t believe your doctor🙄
Are they living in the Stone Age?!
You need vaginal estrogen. It is not the same as systemic HRT (pills or patches). Vaginal estrogen is a very safe localized treatment for vaginal atrophy.
It can take a couple months to heal those tissues but it works. Use it every night for 2 weeks then twice a week. Forever. It also helps to prevent UTIs, another symptom of Genitourinary Syndrome of Menopause.
You will still need to use lots of lube every time, as well as the vaginal estrogen.
Welcome to menopause.
I tried the vaginal estrogen (and lube) and no joy. My gyno said maybe I just need to find the right partner, be in a relationship, and that will help. Meanwhile I don’t date, have sex, or any interest in it because of the pain associated. And I certainly don’t want a full time relationship, just my sex life back, and I didn’t appreciate her subtle attempt to shame that.
Seriously. I’m so angry about men having things like ED and Low T. Meanwhile most of us women aren’t even educated on vaginal atrophy (which I’m now calling VA goddamnit!) and menopause? No. I’m calling that shit Low E from now on. The solution is in the name just like Low T. Unlike menopause which feels so vague by comparison. And what about Low T in women?? We get it too! We need testosterone too! My T level was literally nonexistent and I went on T cream and OHMYGOD. It’s incredible. But of course it’s not covered and $50 for a month’s supply ughhhh.
Anyway, let’s start going to our drs to talk about VA and Low E!! And Low T! (I’m including Progesterone in the Low E package btw.)
Well… if you want a better term for it, the experts are now just calling it “Genitourinary syndrome of menopause” aka GSM because the term “vaginal atrophy” really doesn’t cover everything that’s going on in the whole system.
People might not even be having noticeable GSM symptoms like external atrophy (*waves hand* I get pelvic exams every 3 months for cancer surveillance, and they specifically look for atrophy, so it’s not just me being deluded 😂) but definitely struggle with internal, invisible symptoms like bladder issues, which indicate the GSM is in full swing. Just got diagnosed with it myself. 😮💨
I’m using my estrogen cream now for sure…
Over here where I live, birth control is free for women up to the age of 35 and no mention what happens next, basically after child bearing years women are simply ehemmm written off!! 🤬🤬
My insurance covers the visits to menopause specialist but not the hormones she prescribes which are not prohibitively expensive over here but it all adds up (up to 65€ per month).
That seems crazy. Ignoring the ageism of covering bc but not hormonal treatment for menopause, women still have around 15 years of fertility after age 35.
You're right that most insurances "cover" it, but it seems that men pay less for viagra type products that are covered than what I pay. Also, it seems that the criteria for HRT being covered seems limited - a patient has to say they are having hot flashes. It doesn't seem to be covered unless it's being Rx'd for hot flashes. Doesn't seem to be covered for other sxs of meno. That could be partly due to drs' reluctance to Rx it for anything other than hot flashes, IDK. Also, I know I pay $53/mo for a very low dose combo patch. And that's with good insurance. And then my estrogen cream, although cheaper, is another fee on top of that. I asked my dr. for a cheaper alternative, and no generic of this particular form (combo patch) and dose is available. So that could be the result of just not enough generics and options for HRT tx. I just know that I'm spending a lot on HRT rxs and I don't like it.
I (50) was beginning to have problems with lubrication and it made sex uncomfortable. I'd get wet, but it was too thin and watery. I don't like lube.
After some research on this sub and amazon, I bought Key-E moiturizing suppositories and Enchanted rose balm. I insert half (sometimes one third) a suppository nightly and apply the balm to my vulva. This has been a complete game changer - we now have sex way more frequently and I rarely feel sore after.
I realize that, for many, this might not be enough, but I wanted to start small and this is enough for now.
I’m 51 and on a regular course of vaginal estrogen and Bonifide Reveree vaginal inserts (2 each weekly) and not only has it massively helped with vaginal dryness and pain but weirdly it helps somewhat with stress incontinence as well.
So far I use the regular but will probably try the plus next time I refill because who doesn’t want plus moisture lol. I haven’t tried the Ristela supplements, I don’t know anything about them.
I’ve used MIDI too! Great caring practitioners and my urinary and dryness issues cleared up after getting a vaginal estrogen prescription. So grateful!
How old you feel at 52 has little to do with how your lowered estrogen is affecting your vaginal tissues. Look into all the skin, cardiovascular, cognitive and anti-cancer benefits to HRT. Women are using estrogen on our faces for anti-aging. All the cancer risk rhetoric was bad science.
Vaginal estrogen is a treatment even younger AFAB people need sometimes. My good friend has had inadequate estrogen replacement for a few years and has had to have two separate surgeries for painful clitoral adhesions. Low estrogen affects your vaginal tissues negatively, period. Find a hormone specialist GYN who will be liberal with HRT: estrogen, progesterone and testosterone.
I also use vaginal hyaluronic acid in addition to vaginal estrogen and regular HRT — estrogen patch, testosterone cream and progesterone orally. Also estrogen face cream in addition to my tretinoin. I’m never doing less than that — but I have had chronic illness for years, so the idea of being “natural” is something I gave up on in my 30s.
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Perimenopause usually starts in the 40s. Many women start menopause around age 50, so the timing is pretty normal for you. But definitely see a Dr for the symptoms,. You don't have to suffer, but you do need some medicinal or medical support.
Piling on to say vaginal estrogen. Even having a pap smear was painful much less my boyfriend!
It’s like night and day. Sex is great again! There is hope!
Estradiol cream is probably all you really need. The other stuff may or may not be helpful for you as well, but the real cause is a lack of estrogen in those tissues.
All women should be automatically given vaginal estrogen once they reach a certain age. It's literally INSANE that you could get to 52 and never have a doctor even bring it up. Like WTF society, sexism infuses every single aspect of it apparently.
This is a symptom of menopause. So, go see a different doctor who especializes in menopause and get treatment. FYI, most doctors DO NOT know anything about menopause.
i am 37. around 33-34 i started having burning and it’s on one side only. the first doctor I went to gave me estrogen cream and I didn’t want to use it. I tried it a while maybe a month or so then stopped. I have been to a couple other doctors since then and they say i dont need it. But I have restarted it about 2.5 weeks ago… Do you think the burning from peri can be felt by the patient before it’s seen by the doctor? They say mine looks fine. No signs of estrogen deficiency? I cannot have sex and I’m burning everyday. I’ve been in pelvic floor therapy but it isn’t helping. I do have a lot of muscle or bone pain on left side of body too and she said my muscles in vagina are tight in left side. I have no pain on the right. But it’s not helping.
I am not a doctor but your symptoms sound like vaginismus. There is primary and secondary vaginismus, and maybe you don't need estrogen, but at your age I would have blood work done to determine the levels of hormones. Don't stop looking for an answer, and talk to a doctor about vaginismus because I hear it's treatable.
The average age of menopause is 51; estrogen levels decline for ten years prior. Every woman experiences it differently. I'm only 49, still having regular periods and almost no peri-menopause symptoms EXCEPT for painful sex. Vaginal estrogen cream alternating with vaginal moisturizer (hyaluronic acid) has been a game changer!!
I didn’t have peri-menopause either. I just started having dry razor blade vagina and mild hot flashes at 50 and a year later, I couldn’t take it anymore. My gynecologist said I was starting menopause so she put me on compounded Estriol. My breasts would hurt every month and then it stopped around that time also. I couldn’t gauge my change by menstrual cycles because I had a partial hysterectomy at 43.
I’ve been on the estriol since 2018 and sex doesn’t hurt at all. It also helps with PH balance big time. I haven’t had any yeast or BV at all. My vagina has been very happy since I started my therapy and it’s cheap too(30$ a month)
Have a listen to The Diary of a CEO podcast. He’s had a couple episodes about Menopause (from women Dr’s) and they’re so informative. It’s incredible how little information is out there, and yes, it absolutely should be covered by benefits (but men don’t care) and this needs to change. I hope you find a solution that works for you :)
First, I'm not sure what you were ever taught, but your 50s is the exact time menopause hits for just about everyone. It's not common for it to be beyond that.
Dont try it all at once. You want to actually know what REALLY helps when you start trying things, so do one thing at a time.
First, do you use lube? Use it, and use a lot of it.
If that still doesn't seem to do the job, get your horomone levels tested to see if you are, in fact, in menopause or just perimenopause. If this is the case, HRT can help. It's not as scary as people believe it is. Do some research (even just searching this sub for info about HRT can be a huge help).
Then, if you still seem to have discomfort, try pelvic floor therapy. If you need dilators or anything of the sort they'll tell you there.
There is NO hormone testing needed to confirm menopause, it is PURELY symptom-based therapy. The ONLY time that hormonal testing is required is to diagnose POS &/or if a woman stops bleeding before the age of 40. IF a doc says they are going to test for menopause, that is a clear indication of a red flag event - in which case fire your Doc & get to hunting for one who will validate your symptoms & better yet provide proven HRT treatment. After all menopause IS a natural process, so there is nothing abnormal about it.
Thanks for the clarification. I'm 35 and just had a hysterectomy, so I HAVE to get horomones tested to know if I'm in menopause or not. I didn't realize it was different for those with periods.
Precisely! ANYTIME when bleeding stops BEFORE the age of 40 (which you are) warrants hormonal testing to rule out conditions that potentially might be the culprit.🫶🏽
Were your ovaries also removed?
No, but I'm getting peri symptoms. I'm getting my horomone levels checked this week (for the first time anyway, likely again in a month) to see if it's just my body adjusting still or if I need HRT.
It’s great that you do still have your ovaries! Sorry for the issues you are enduring dear one, may this all be ironed out swiftly so you can begin to feel more like yourself again🩵
The oestrogen cream (Ovestin) may help - you can purchase it online or get from your GP. You might have vulvodynia or vestibule vulvodynia- this makes you feel like there’s a patch of soreness inside or like a ‘stripe’ of bumpy rash. You show it to a gynaecologist and they can’t see it. Very frustrating. At the age you’re at, oestrogen cream is given, along with vaginal moisturiser like ‘yes’. The doctors don’t seem to get it. There’s a book online called “My Menopausal Vagina” it’s v good, maybe worth a try
They didn’t Rx you estradiol?
You likely are having vaginal atrophy.
I had it when I was nursing. It was awful. It felt like my husband dipped his dick in glass shards and tried to screw me.
Get super runny water based lube. Kit the jelly shit. It don’t work well!
But also ask for an Rx of estradiol. I think you put it vaginally for 2 weeks, and then once weekly for 2 weeks. And the. I think you can put it just on your vulva a couple times a week for upkeep.
I am only just learning about vaginal atrophy from this sub and you may want to read up on it. I’m calling it VA bc if men can have ED then we can have a name like VA too. Hrt will help you but you need a topical estrogen also to deal more directly with the VA. And it wouldn’t hurt to get your testosterone level checked too (which is possible with bloodwork since it doesn’t fluctuate wildly like estrogen does). My T level was basically zero. I had none. So I went on T cream and goddamn. It’s helping me so much. I can’t stop talking about it and recommending it to others who also have Low T (which is possible for women just like it is for men!). Good luck!! I hope you find a good dr who will help you soon! Don’t settle until you get the help you need and deserve!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause.
FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more.
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Get some Uberlube. And use it liberally. After 50 our skin gets thinner and we have less natural lubrication so everything feels rougher. Uberlube is totally worth the money - the closest thing to our own natural lubrication that I have found. And I’m very grateful that someone here recommended it.
All the ideas above are most excellent. Are they reasonable sized bumps? I have a rectocele from having babies. Lucky me…not. It causes pain when pushed on when there is solid poop on the other side. OMG! I can’t believe I just wrote that. I hope you find a solution.
I had the same problem. Went on estrogen cream, which helped somewhat with dryness, but sex was still painful even with loads of lube. Gyno put me on something called ABG cream. It’s a compound med, so insurance didn’t cover it, but the $50 a month is totally worth it. Worked like a charm for me!
Everyone here is "YOU NEED ESTROGEN!!!" But I have the same thing as you, migraines and even topical estrogen causes serious migraine with aura and stroke-like symptoms. It sucks.
After menopause, vaginal walls are thinner and not as elastic. They call it vaginal atrophy. I'm 60 years old, post menopausal and recently stopped hrt. I don't have a regular partner, and I don't have sex very often ... as in: years. I was once celibate for 11 consecutive years! Sex doesn't hurt me ( last guy could last for hours) ... until the morning after. Penetration burns the morning after. It's like I can feel all of the little tears that were created from all the thrusting from the night before! I make plenty of natural lubrication... with barely any foreplay. I'm lucky in that respect, I guess... but I digress. I recommend using plenty of lube, and using a dildo when you self pleasure (I recently started doing that). Hrt also helps.
Yes. You do have to pay for meds, and maybe PT and tools to help your rehab if you want to have comfortable, enjoyable sex again. This issue will not resolve on its own. Get to a practitioner, or see on an online practitioner, who will prescribe vaginal estrogen therapy to start. That may be all you need.
Vaginal estrogen cream or inserts. Trust all the ladies on here telling you this and save yourself more suffering if possible. Just oral or transdermal estrogen is often not enough to treat GSM (symptoms include: vaginal dryness, tightness, shrinkage, and itching) and you’ll need a topical or direct treatment of estrogen. It’s localized (stays in vaginal tissues) so is mostly very safe and VERY effective. Couple tips: it usually takes about 2-3 months to really see and feel the difference depending how far along you are with GSM, doctors routinely under-dose the starting protocol so for many, daily use for a few weeks in the beginning is necessary before backing down to 2-3x/s weekly.
Anecdote: prior to getting on vaginal estrogen last Sept, my husband and I couldn’t have sex anymore, even when we both wanted to, because of what you’re describing above. The weekend the vaginal estrogen really kicked in and all systems were “go” as far as me feeling ready and my vagina finally looking like a vagina again and not a flip flop left out in the sun, I jumped my poor husband 3xs in one day after MONTHS of nothing. TL;DR: he threw his back out and spent the rest of the week mumbling, “don’t you even look at me right now!” 😆🚀
Vaginal atrophy due to lack of estradiol. Solution is a combo of heavy dosing HRT plus estradiol vaginal creme and suppositories. In this case, more is better, get as much as you can take. If it becomes too much, dial back a bit on the dosing, and then go up again.
Women's healthcare is abysmal. I had painful sex and saw a ton of drs until finally giving up and going celibate. Randomly my iud was "lost" and they HAD to order an ultrasound. Come to find out one of my ovaries was completely consumed by cysts. It was 2x the size and had been painfully growing but my gp, my gyno and the specialist all missed it. The then discovered fibroids in my uterus.
They do not care about women over 40.
Hormone replacement and lube it your best friend! I know most information says not to use oil based lube, but my hubby and I depend in it! I can't believe we ever had sex without it. I rub on him and he loves it, he rubs on me and it's great foreplay to get ready. Lube, lube, and more lube at this age!
Only 52.. Girl that is the age bracket to be in Menopause if your cycles have stopped for over a year. Othewise you are in Peri/menopause. You need to talk to a menopause Dr who specializes and not your normal PC or Gynecologist. Its called Vaginal Atrophy and it dries you out so bad, you can be cut and bleed and everything trying to have sex. I didn't have a bump feeling but I was dry as sandpaper and nothing you do even using lube helps with that kind of dryness.
I would definitely try to get an estradiol cream, you can also try some natural products. I take some natural pills made by Her Juice Bar, called the wet martini and they worked better than the vaginal estrogen with keeping me wet and having me to produce wetness during sex.
You have to educate yourself and not count on every Dr to even have that information. My primary care had very little information, I have been updating her as I have found things out so she can share with her other patients that have the same issues.
I am 52 and had the same issues regarding dryness and painful sex. I did not think I was in menopause as I wasn't having hot flashes or other common symptoms of menopause. What I did have was brain fog, facial hair growth, fatigue, and muscle pains. Neither my GYN or PCP mentioned HRT. When I asked about it, my GYN didn't want to prescribe it to me. I started googling my symptoms and found this reddit forum. Because of the ladies here, I decided to take my sexual health into my own hands and find a place to get hormone replacement therapy. I signed up with Evernow in January 2024, and I can not express how much I love this service. If I have any issues or questions, i send a chat to the doctor, and she gets back to me within a few hours. I started on estrogen patches, progesterone, and estrogen vaginally. It's made a HUGE difference in my brain fog, mood, vaginal dryness, and my sex life. Also, if you have health insurance, you can use it for the prescriptions as they will send it to your regular pharmacy.
Use my referral link, and you’ll get $25 off the first month's membership. [Evernow ](https://care.evernow.com/start?referral_code=2iMgZQVM)
Try a vagina moisturizer, too. I use it every three nights before bed, or if I know I plan to have sex the next day I will use one tbe night before. Helps tremendously. I am also on HRT and not recommending against that at all, but as a quick approach before you can get that all worked out, try it. My favorite is Ah Yes but you have to order that. Replens from the drugstore is also decent and you can pick that up today! Good luck!
I started peri at 36. Every single symptom, still even. (47) my sister, at 52, only symptoms were very mild hot flashes and very moody. She had no idea till the drs told her. She still has no other symptoms and started hrt for her measly flashes.( I day this in anger as I wake up with wet pillow often. She has no idea what a real flash is)
I take DHEA (1/10 of a 100mg tablet per day) and Pregnenolone (1/5 of a 100mg tablet per day). It has been amazing to see myself return to what I was like 10 years ago. I didn't even realize I had changed. Or that I had brain fog. Things happened so slowly that I hadn't seen it. The veil was lifted WITHIN A DAY. My muscle tone is returning. I can have sex without pain. I am 48 and I had a very painful and stressful 5 years, so I think that's why I went into perimenopause so early... Anyway, these supplements are inexpensive and you don't need much. Don't take as much as is in the capsules... I have enough for three years in one bottle of DHEA...
BTW, I use the Naturbell brand. I tried another one and it did nothing. More background on me, I take escitalopram for anxiety and I take vitamin D because menopause has made me start losing my vitamin D and I believe it also caused my autoimmune problems, some of which have gone away with supplements.
They are sold in gel capsules. Gel capsules have little nibs on the ends. I open the gel capsules and use the tip of the small end to measure about a 10th or less of DHEA (similar for Pregnenolona). I pour that into a spoon and take a sip of water, then add that to the water I just took. I tried it with nothing in my mouth once and accidental inhalation caused some to get in my air tubes which felt uncomfortable. So I mix it in my mouth and swallow. It's such a small amount that I would be afraid of mixing it in a cup - it might attach to the sides. I know it's not perfectly exact, but at least I'm not taking 100 mg at a time. It doesn't seem to cause a problem. I wish there were a way for me to measure it out perfectly, but this seems to work.
I started Estoridal at 39. I had a partial hysterectomy. I have bumps only on 1 side and doctor said it is perfectly normal.
I do the cream once a week and I've been fine for over 13 years. I get mammograms and pelvic exam every year.
I smoke cigs and drink wine almost daily. No problems whatsoever. Good luck to you.
I think you need to go back to your doctor and be explicit about the pain during intercourse. You need an ex-ray done first and foremost.
There are many comments about the menopause, you may or may not be and just to be sure about hormones you might want to bring it up to your doctor. Maybe get some blood tests too.
In the meantime, you and your boyfriend can do other things that bring you both pleasure. Hope everything works out in your favour.
Vaginal estrogen, also there are some suppositories that are over the counter and can help in the meantime. Vitamin E, there are some cheaper ones and some from Bonafide that are more expensive.
A 52 year old woman going to the doctor and telling them sex hurts and the doctors not immediately talking about menopause is like a 12 year old girl going to the doctor and telling them she's bleeding from her vagina and the doctor not immediately talking about menstruation. "Let's run some tests." It's mind boggling how ignorant some doctors are.
YES
Exactly. It’s wild doctors are so uneducated on menopause! “Here, have some antidepressants!”
Oh yeah! I've heard that one before. I basically told Dr. To "F" off.
👏
YES! Absofrickinlutely mind boggling!! She needs a new medical team...yesterday.
This happened to me too at the doctor's. If not for these forums I never would have known.
OMG SO MUCH THIS ☝️☝️☝️
I KNOW… I was like Whuh?!?!? 🤦🏻♀️
At the very least someone should’ve prescribed .01mg estradiol vaginal cream.
Yes! It has helped me tremendously
The answer.
Yes and that can be used on your face as well !
The average age for menopause is 51. Estrogen cream. Yesterday
I started having pain with sex around the same age. I saw a women’s health specialist (usually gyn not ob). Even though I still had irregular periods, blood work showed I was in menopause. HRT pellets changed everything for me. I now have my libido back as well as pleasure with sexual activity. Don’t stop trying to find your solution. Sex should continue to be a natural and pleasurable experience for you even as we age. Good luck!
Thank you for giving me hope!
I had this same issue way younger than you, OP. The hormone cream and also DHEA has turned things around 100%.
I was lucky that just before menopause I saw a hormone specialist NP and she gave me HRT and vaginal estrogen and manually separated my clitoral hood adhesions — which I didn’t even know was a thing. She told me I already had significant atrophy, but vaginal estrogen might reverse it. (My poor bestie has had two surgeries for painful clitoral adhesions.) Not to scare OP further, but low estrogen can cause your external clit to atrophy entirely. Look it up, it’s terrifying and it’s happened to many older ladies who were denied proper HRT due to unfounded fears of cancer.
How old were you when you saw a hormone specialist?
Late 40s. Then went into menopause at 51, right on the dot.
Same…. Just turned 50 last month and haven’t had a period in a year.
What!? That can happen!!
Absolutely. Mine just disappeared. It was really freaky. (I felt like a certain scene in Handmaid's Tale, it was horrifying) Thank goodness for hormones
What you need is vagina estrogen, either cream or pessary/pill. Depending on how advanced the vaginal atrophy is, you might need dilators, but it's not common. This is definitely a symptom of perimenopause, so you can't really say that you don't have any symptoms. Doctors sadly aren't always knowledgeable about perimenopause and you'll have to advocate for yourself.
HRT will be your friend. Before I started HRT it felt like I was being stabbed during intercourse (I know, sounds harsh). Also Grapeseed oil is a good lubricant. I can’t believe your doctor🙄 Are they living in the Stone Age?!
Oil lubricants are the way to go, if you have a regular partner and don’t use condoms.
Ya. Have my steady partner/hubs. We have a dedicated waterproof sex blanket,too ! Oh so romantic!
Ha, ha! Me too!😜
You need vaginal estrogen. It is not the same as systemic HRT (pills or patches). Vaginal estrogen is a very safe localized treatment for vaginal atrophy. It can take a couple months to heal those tissues but it works. Use it every night for 2 weeks then twice a week. Forever. It also helps to prevent UTIs, another symptom of Genitourinary Syndrome of Menopause. You will still need to use lots of lube every time, as well as the vaginal estrogen. Welcome to menopause.
I tried the vaginal estrogen (and lube) and no joy. My gyno said maybe I just need to find the right partner, be in a relationship, and that will help. Meanwhile I don’t date, have sex, or any interest in it because of the pain associated. And I certainly don’t want a full time relationship, just my sex life back, and I didn’t appreciate her subtle attempt to shame that.
51 is the average age of menopause.
And perimenopause starts way earlier....
and many of us will barely be able to even see menopause in the rear view mirror by then, it will be so far in the past.
if men can get viagra covered why in god's name is estrogen not covered by all insurances? let's all complain to our legislators.
Seriously. I’m so angry about men having things like ED and Low T. Meanwhile most of us women aren’t even educated on vaginal atrophy (which I’m now calling VA goddamnit!) and menopause? No. I’m calling that shit Low E from now on. The solution is in the name just like Low T. Unlike menopause which feels so vague by comparison. And what about Low T in women?? We get it too! We need testosterone too! My T level was literally nonexistent and I went on T cream and OHMYGOD. It’s incredible. But of course it’s not covered and $50 for a month’s supply ughhhh. Anyway, let’s start going to our drs to talk about VA and Low E!! And Low T! (I’m including Progesterone in the Low E package btw.)
Perhaps low E/P would be a good fit
I like it.
Well… if you want a better term for it, the experts are now just calling it “Genitourinary syndrome of menopause” aka GSM because the term “vaginal atrophy” really doesn’t cover everything that’s going on in the whole system. People might not even be having noticeable GSM symptoms like external atrophy (*waves hand* I get pelvic exams every 3 months for cancer surveillance, and they specifically look for atrophy, so it’s not just me being deluded 😂) but definitely struggle with internal, invisible symptoms like bladder issues, which indicate the GSM is in full swing. Just got diagnosed with it myself. 😮💨 I’m using my estrogen cream now for sure…
I was today years old when I heard the term vaginal atrophy….
I remember that day for me, wasn’t so long ago. Someone just told me that it’s also being called Genitourinary Syndrome of Menopause, or GSM.
Over here where I live, birth control is free for women up to the age of 35 and no mention what happens next, basically after child bearing years women are simply ehemmm written off!! 🤬🤬 My insurance covers the visits to menopause specialist but not the hormones she prescribes which are not prohibitively expensive over here but it all adds up (up to 65€ per month).
That seems crazy. Ignoring the ageism of covering bc but not hormonal treatment for menopause, women still have around 15 years of fertility after age 35.
I saw a post that said its telling that the medical terminology for aging vaginas is "atrophy" but the penis is only "dysfunction"
We are still not as important as men …
Estrogen is covered by insurance here where I live….Never heard of it not being covered.
You're right that most insurances "cover" it, but it seems that men pay less for viagra type products that are covered than what I pay. Also, it seems that the criteria for HRT being covered seems limited - a patient has to say they are having hot flashes. It doesn't seem to be covered unless it's being Rx'd for hot flashes. Doesn't seem to be covered for other sxs of meno. That could be partly due to drs' reluctance to Rx it for anything other than hot flashes, IDK. Also, I know I pay $53/mo for a very low dose combo patch. And that's with good insurance. And then my estrogen cream, although cheaper, is another fee on top of that. I asked my dr. for a cheaper alternative, and no generic of this particular form (combo patch) and dose is available. So that could be the result of just not enough generics and options for HRT tx. I just know that I'm spending a lot on HRT rxs and I don't like it.
I (50) was beginning to have problems with lubrication and it made sex uncomfortable. I'd get wet, but it was too thin and watery. I don't like lube. After some research on this sub and amazon, I bought Key-E moiturizing suppositories and Enchanted rose balm. I insert half (sometimes one third) a suppository nightly and apply the balm to my vulva. This has been a complete game changer - we now have sex way more frequently and I rarely feel sore after. I realize that, for many, this might not be enough, but I wanted to start small and this is enough for now.
OP try to get vaginal estrogen, it does wonders to help improve the genitourinary syndrome of menopause (GSM)
I’m 51 and on a regular course of vaginal estrogen and Bonifide Reveree vaginal inserts (2 each weekly) and not only has it massively helped with vaginal dryness and pain but weirdly it helps somewhat with stress incontinence as well.
This is my regime...it works!
I have been looking into the Reveree - you found it makes a noticeable difference?
Absolutely. My doctor recommended it originally and I used it exclusively for two years before I started the Yuvafem.
Do you use the “regular” or the”plus”? Also, have you tried the Ristela supplements?
So far I use the regular but will probably try the plus next time I refill because who doesn’t want plus moisture lol. I haven’t tried the Ristela supplements, I don’t know anything about them.
Exactly! Why not have moisture plus? 😂
I just posted this huge PSA about vaginal estrogen a few days ago. Please read it! https://www.reddit.com/r/Menopause/s/vd48rKNQkc
"I have no symptoms..." This is a symptom. I'll bet if you reflected more carefully, you'd find others.
Use MIDI health. They take insurance. You need a patch and cream. Most Doctors know nothing about menopause.
I’ve used MIDI too! Great caring practitioners and my urinary and dryness issues cleared up after getting a vaginal estrogen prescription. So grateful!
How old you feel at 52 has little to do with how your lowered estrogen is affecting your vaginal tissues. Look into all the skin, cardiovascular, cognitive and anti-cancer benefits to HRT. Women are using estrogen on our faces for anti-aging. All the cancer risk rhetoric was bad science. Vaginal estrogen is a treatment even younger AFAB people need sometimes. My good friend has had inadequate estrogen replacement for a few years and has had to have two separate surgeries for painful clitoral adhesions. Low estrogen affects your vaginal tissues negatively, period. Find a hormone specialist GYN who will be liberal with HRT: estrogen, progesterone and testosterone. I also use vaginal hyaluronic acid in addition to vaginal estrogen and regular HRT — estrogen patch, testosterone cream and progesterone orally. Also estrogen face cream in addition to my tretinoin. I’m never doing less than that — but I have had chronic illness for years, so the idea of being “natural” is something I gave up on in my 30s.
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Perimenopause usually starts in the 40s. Many women start menopause around age 50, so the timing is pretty normal for you. But definitely see a Dr for the symptoms,. You don't have to suffer, but you do need some medicinal or medical support.
Piling on to say vaginal estrogen. Even having a pap smear was painful much less my boyfriend! It’s like night and day. Sex is great again! There is hope!
Estradiol cream is probably all you really need. The other stuff may or may not be helpful for you as well, but the real cause is a lack of estrogen in those tissues. All women should be automatically given vaginal estrogen once they reach a certain age. It's literally INSANE that you could get to 52 and never have a doctor even bring it up. Like WTF society, sexism infuses every single aspect of it apparently.
My tube (of estradiol cream) is on its way. I’m 53
That’s medical malpractice and MADDENING
This is a symptom of menopause. So, go see a different doctor who especializes in menopause and get treatment. FYI, most doctors DO NOT know anything about menopause.
i am 37. around 33-34 i started having burning and it’s on one side only. the first doctor I went to gave me estrogen cream and I didn’t want to use it. I tried it a while maybe a month or so then stopped. I have been to a couple other doctors since then and they say i dont need it. But I have restarted it about 2.5 weeks ago… Do you think the burning from peri can be felt by the patient before it’s seen by the doctor? They say mine looks fine. No signs of estrogen deficiency? I cannot have sex and I’m burning everyday. I’ve been in pelvic floor therapy but it isn’t helping. I do have a lot of muscle or bone pain on left side of body too and she said my muscles in vagina are tight in left side. I have no pain on the right. But it’s not helping.
I am not a doctor but your symptoms sound like vaginismus. There is primary and secondary vaginismus, and maybe you don't need estrogen, but at your age I would have blood work done to determine the levels of hormones. Don't stop looking for an answer, and talk to a doctor about vaginismus because I hear it's treatable.
The average age of menopause is 51; estrogen levels decline for ten years prior. Every woman experiences it differently. I'm only 49, still having regular periods and almost no peri-menopause symptoms EXCEPT for painful sex. Vaginal estrogen cream alternating with vaginal moisturizer (hyaluronic acid) has been a game changer!!
Is the vaginal moisturizer a prescription or over the counter? What brand do you use?
It's over the counter. It's called Feel-Amazing. There are lots of good brands out there
🙏
OTC.
I didn’t have peri-menopause either. I just started having dry razor blade vagina and mild hot flashes at 50 and a year later, I couldn’t take it anymore. My gynecologist said I was starting menopause so she put me on compounded Estriol. My breasts would hurt every month and then it stopped around that time also. I couldn’t gauge my change by menstrual cycles because I had a partial hysterectomy at 43. I’ve been on the estriol since 2018 and sex doesn’t hurt at all. It also helps with PH balance big time. I haven’t had any yeast or BV at all. My vagina has been very happy since I started my therapy and it’s cheap too(30$ a month)
Estrogen cream is available cheaply in generic form. Clearly you need it and are of menopausal age. Symptoms start before periods stop.
Where are you ladies getting T cream?
“The new menopause” by Mary Clare haver
Try being under 40 and having it happen. Do you use lube? And yes, sounds like you need vaginal estrogen.
Have a listen to The Diary of a CEO podcast. He’s had a couple episodes about Menopause (from women Dr’s) and they’re so informative. It’s incredible how little information is out there, and yes, it absolutely should be covered by benefits (but men don’t care) and this needs to change. I hope you find a solution that works for you :)
There’s a pinned post in this sub all about vaginal estradiol. Lots of information in it that you might find helpful.
Vaginal atrophy is the pits. The estrogen cream should do the trick.
First, I'm not sure what you were ever taught, but your 50s is the exact time menopause hits for just about everyone. It's not common for it to be beyond that. Dont try it all at once. You want to actually know what REALLY helps when you start trying things, so do one thing at a time. First, do you use lube? Use it, and use a lot of it. If that still doesn't seem to do the job, get your horomone levels tested to see if you are, in fact, in menopause or just perimenopause. If this is the case, HRT can help. It's not as scary as people believe it is. Do some research (even just searching this sub for info about HRT can be a huge help). Then, if you still seem to have discomfort, try pelvic floor therapy. If you need dilators or anything of the sort they'll tell you there.
There is NO hormone testing needed to confirm menopause, it is PURELY symptom-based therapy. The ONLY time that hormonal testing is required is to diagnose POS &/or if a woman stops bleeding before the age of 40. IF a doc says they are going to test for menopause, that is a clear indication of a red flag event - in which case fire your Doc & get to hunting for one who will validate your symptoms & better yet provide proven HRT treatment. After all menopause IS a natural process, so there is nothing abnormal about it.
Thanks for the clarification. I'm 35 and just had a hysterectomy, so I HAVE to get horomones tested to know if I'm in menopause or not. I didn't realize it was different for those with periods.
Precisely! ANYTIME when bleeding stops BEFORE the age of 40 (which you are) warrants hormonal testing to rule out conditions that potentially might be the culprit.🫶🏽 Were your ovaries also removed?
No, but I'm getting peri symptoms. I'm getting my horomone levels checked this week (for the first time anyway, likely again in a month) to see if it's just my body adjusting still or if I need HRT.
It’s great that you do still have your ovaries! Sorry for the issues you are enduring dear one, may this all be ironed out swiftly so you can begin to feel more like yourself again🩵
How did you get pelvic floor therapy paid for??
I'm in Canada, so it just went through the health benefits I get through work. But they work 100% different in Canada than US.
That's excellent!
I needed vaginal estrogen by 46. You are privileged to be able to wait so long. Sorry your dr sucks. Get meds.
Sex hurt way more than losing virginity. Multiday, non-ignorable burning pain. Like never do it again hurt. Get the cream.
Vaginal estrogen in the very least. Educate yourself and advocate for yourself. Many doctors are sorely lacking in their menopause knowledge.
The oestrogen cream (Ovestin) may help - you can purchase it online or get from your GP. You might have vulvodynia or vestibule vulvodynia- this makes you feel like there’s a patch of soreness inside or like a ‘stripe’ of bumpy rash. You show it to a gynaecologist and they can’t see it. Very frustrating. At the age you’re at, oestrogen cream is given, along with vaginal moisturiser like ‘yes’. The doctors don’t seem to get it. There’s a book online called “My Menopausal Vagina” it’s v good, maybe worth a try
They didn’t Rx you estradiol? You likely are having vaginal atrophy. I had it when I was nursing. It was awful. It felt like my husband dipped his dick in glass shards and tried to screw me. Get super runny water based lube. Kit the jelly shit. It don’t work well! But also ask for an Rx of estradiol. I think you put it vaginally for 2 weeks, and then once weekly for 2 weeks. And the. I think you can put it just on your vulva a couple times a week for upkeep.
Why didn’t doctors tell you? They’re idiots when in comes to menopause. You need estrogen vaginal cream. 52 is prime menopause age hun.
You *are* having symptoms and you're 52. Get some HRT, including cream And doctors can be dumbasses
I am only just learning about vaginal atrophy from this sub and you may want to read up on it. I’m calling it VA bc if men can have ED then we can have a name like VA too. Hrt will help you but you need a topical estrogen also to deal more directly with the VA. And it wouldn’t hurt to get your testosterone level checked too (which is possible with bloodwork since it doesn’t fluctuate wildly like estrogen does). My T level was basically zero. I had none. So I went on T cream and goddamn. It’s helping me so much. I can’t stop talking about it and recommending it to others who also have Low T (which is possible for women just like it is for men!). Good luck!! I hope you find a good dr who will help you soon! Don’t settle until you get the help you need and deserve!
It sounds like this might be about hormonal testing. If over the age of 44, **hormonal tests only show levels for that *one day* the test was taken, and nothing more**; progesterone/estrogen hormones wildly fluctuate the other 29 days of the month. No reputable doctor or menopause society recommends hormonal testing as a **diagnosing tool** for peri/menopause. FSH testing is only beneficial for those who believe they are post-menopausal and no longer have periods as a guide, a series of consistent FSH tests might *confirm* menopause. Also for women in their 20s/early 30s who haven’t had a period in months/years, then FSH tests at ‘menopausal’ levels, could indicate premature ovarian failure/primary ovarian insufficiency (POF/POI). See our [Menopause Wiki](https://menopausewiki.ca/#there-is-no-blood-test-that-is-perfectly-reliable-to-diagnose-menopause) for more. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Menopause) if you have any questions or concerns.*
What were the greatest benefits you saw with the t cream? My Dr prescribed estradiol pills based on symptoms. No tests run, so not sure if I'm low t.
Improved energy, improved workouts, improved orgasms, and the more intangible “feeling more like myself again”.
Get some Uberlube. And use it liberally. After 50 our skin gets thinner and we have less natural lubrication so everything feels rougher. Uberlube is totally worth the money - the closest thing to our own natural lubrication that I have found. And I’m very grateful that someone here recommended it.
Ok I just ordered some!!
Also Google Vaginismus, hopefully you can find a doctor who wants to listen and get some vaginal estrogen.
All the ideas above are most excellent. Are they reasonable sized bumps? I have a rectocele from having babies. Lucky me…not. It causes pain when pushed on when there is solid poop on the other side. OMG! I can’t believe I just wrote that. I hope you find a solution.
I had the same problem. Went on estrogen cream, which helped somewhat with dryness, but sex was still painful even with loads of lube. Gyno put me on something called ABG cream. It’s a compound med, so insurance didn’t cover it, but the $50 a month is totally worth it. Worked like a charm for me!
Lots of pre-time and lube was our answer right now-you may need vaginal cream or supplements
Listen to this, it has a ton on info for you https://open.spotify.com/episode/6bSCqtpHijepXHeKzSwEw4?si=bN4S7Vt1TxCgoKjHGJtcnQ
You need HRT. Your age doesn't matter. Also, have you tried having non vaginally sex? Just a thought...
I use Yes! hyaluronic suppositories since I’m unable to use any form of estrogen due to migraines. Even topical causes them.
Everyone here is "YOU NEED ESTROGEN!!!" But I have the same thing as you, migraines and even topical estrogen causes serious migraine with aura and stroke-like symptoms. It sucks.
Have you found anything that eases most of the symptoms? The only thing that works for me is an intense workout yet I’m still 30 lbs overweight 🤦♀️
Yeah, exercise, somewhat. Lifting and yoga. Hyaluronic acid for the v. Helps but doesn't fix everything. Still dealing with atrophy.
Have you tried the hyaluronic suppositories? They’re for daily use and seem to be helping a little.
Yeah, that's what I meant- suppositories. They help a bit.
After menopause, vaginal walls are thinner and not as elastic. They call it vaginal atrophy. I'm 60 years old, post menopausal and recently stopped hrt. I don't have a regular partner, and I don't have sex very often ... as in: years. I was once celibate for 11 consecutive years! Sex doesn't hurt me ( last guy could last for hours) ... until the morning after. Penetration burns the morning after. It's like I can feel all of the little tears that were created from all the thrusting from the night before! I make plenty of natural lubrication... with barely any foreplay. I'm lucky in that respect, I guess... but I digress. I recommend using plenty of lube, and using a dildo when you self pleasure (I recently started doing that). Hrt also helps.
Yes. You do have to pay for meds, and maybe PT and tools to help your rehab if you want to have comfortable, enjoyable sex again. This issue will not resolve on its own. Get to a practitioner, or see on an online practitioner, who will prescribe vaginal estrogen therapy to start. That may be all you need.
Vaginal estrogen cream or inserts. Trust all the ladies on here telling you this and save yourself more suffering if possible. Just oral or transdermal estrogen is often not enough to treat GSM (symptoms include: vaginal dryness, tightness, shrinkage, and itching) and you’ll need a topical or direct treatment of estrogen. It’s localized (stays in vaginal tissues) so is mostly very safe and VERY effective. Couple tips: it usually takes about 2-3 months to really see and feel the difference depending how far along you are with GSM, doctors routinely under-dose the starting protocol so for many, daily use for a few weeks in the beginning is necessary before backing down to 2-3x/s weekly. Anecdote: prior to getting on vaginal estrogen last Sept, my husband and I couldn’t have sex anymore, even when we both wanted to, because of what you’re describing above. The weekend the vaginal estrogen really kicked in and all systems were “go” as far as me feeling ready and my vagina finally looking like a vagina again and not a flip flop left out in the sun, I jumped my poor husband 3xs in one day after MONTHS of nothing. TL;DR: he threw his back out and spent the rest of the week mumbling, “don’t you even look at me right now!” 😆🚀
Vaginal atrophy due to lack of estradiol. Solution is a combo of heavy dosing HRT plus estradiol vaginal creme and suppositories. In this case, more is better, get as much as you can take. If it becomes too much, dial back a bit on the dosing, and then go up again.
Women's healthcare is abysmal. I had painful sex and saw a ton of drs until finally giving up and going celibate. Randomly my iud was "lost" and they HAD to order an ultrasound. Come to find out one of my ovaries was completely consumed by cysts. It was 2x the size and had been painfully growing but my gp, my gyno and the specialist all missed it. The then discovered fibroids in my uterus. They do not care about women over 40.
Hormone replacement and lube it your best friend! I know most information says not to use oil based lube, but my hubby and I depend in it! I can't believe we ever had sex without it. I rub on him and he loves it, he rubs on me and it's great foreplay to get ready. Lube, lube, and more lube at this age!
Only 52.. Girl that is the age bracket to be in Menopause if your cycles have stopped for over a year. Othewise you are in Peri/menopause. You need to talk to a menopause Dr who specializes and not your normal PC or Gynecologist. Its called Vaginal Atrophy and it dries you out so bad, you can be cut and bleed and everything trying to have sex. I didn't have a bump feeling but I was dry as sandpaper and nothing you do even using lube helps with that kind of dryness. I would definitely try to get an estradiol cream, you can also try some natural products. I take some natural pills made by Her Juice Bar, called the wet martini and they worked better than the vaginal estrogen with keeping me wet and having me to produce wetness during sex. You have to educate yourself and not count on every Dr to even have that information. My primary care had very little information, I have been updating her as I have found things out so she can share with her other patients that have the same issues.
I am 52 and had the same issues regarding dryness and painful sex. I did not think I was in menopause as I wasn't having hot flashes or other common symptoms of menopause. What I did have was brain fog, facial hair growth, fatigue, and muscle pains. Neither my GYN or PCP mentioned HRT. When I asked about it, my GYN didn't want to prescribe it to me. I started googling my symptoms and found this reddit forum. Because of the ladies here, I decided to take my sexual health into my own hands and find a place to get hormone replacement therapy. I signed up with Evernow in January 2024, and I can not express how much I love this service. If I have any issues or questions, i send a chat to the doctor, and she gets back to me within a few hours. I started on estrogen patches, progesterone, and estrogen vaginally. It's made a HUGE difference in my brain fog, mood, vaginal dryness, and my sex life. Also, if you have health insurance, you can use it for the prescriptions as they will send it to your regular pharmacy. Use my referral link, and you’ll get $25 off the first month's membership. [Evernow ](https://care.evernow.com/start?referral_code=2iMgZQVM)
It might be a good idea to speak to a different doctor about your concerns.
Try a vagina moisturizer, too. I use it every three nights before bed, or if I know I plan to have sex the next day I will use one tbe night before. Helps tremendously. I am also on HRT and not recommending against that at all, but as a quick approach before you can get that all worked out, try it. My favorite is Ah Yes but you have to order that. Replens from the drugstore is also decent and you can pick that up today! Good luck!
I started peri at 36. Every single symptom, still even. (47) my sister, at 52, only symptoms were very mild hot flashes and very moody. She had no idea till the drs told her. She still has no other symptoms and started hrt for her measly flashes.( I day this in anger as I wake up with wet pillow often. She has no idea what a real flash is)
I take DHEA (1/10 of a 100mg tablet per day) and Pregnenolone (1/5 of a 100mg tablet per day). It has been amazing to see myself return to what I was like 10 years ago. I didn't even realize I had changed. Or that I had brain fog. Things happened so slowly that I hadn't seen it. The veil was lifted WITHIN A DAY. My muscle tone is returning. I can have sex without pain. I am 48 and I had a very painful and stressful 5 years, so I think that's why I went into perimenopause so early... Anyway, these supplements are inexpensive and you don't need much. Don't take as much as is in the capsules... I have enough for three years in one bottle of DHEA... BTW, I use the Naturbell brand. I tried another one and it did nothing. More background on me, I take escitalopram for anxiety and I take vitamin D because menopause has made me start losing my vitamin D and I believe it also caused my autoimmune problems, some of which have gone away with supplements.
How do you split the tablets into such small doses?
They are sold in gel capsules. Gel capsules have little nibs on the ends. I open the gel capsules and use the tip of the small end to measure about a 10th or less of DHEA (similar for Pregnenolona). I pour that into a spoon and take a sip of water, then add that to the water I just took. I tried it with nothing in my mouth once and accidental inhalation caused some to get in my air tubes which felt uncomfortable. So I mix it in my mouth and swallow. It's such a small amount that I would be afraid of mixing it in a cup - it might attach to the sides. I know it's not perfectly exact, but at least I'm not taking 100 mg at a time. It doesn't seem to cause a problem. I wish there were a way for me to measure it out perfectly, but this seems to work.
I started Estoridal at 39. I had a partial hysterectomy. I have bumps only on 1 side and doctor said it is perfectly normal. I do the cream once a week and I've been fine for over 13 years. I get mammograms and pelvic exam every year. I smoke cigs and drink wine almost daily. No problems whatsoever. Good luck to you.
Get a pelvic wand on Amazon and watch some YouTube videos on doing self pelvic floor PT. Also, look up 4/7/8 breathing.
You need Revaree
I think you need to go back to your doctor and be explicit about the pain during intercourse. You need an ex-ray done first and foremost. There are many comments about the menopause, you may or may not be and just to be sure about hormones you might want to bring it up to your doctor. Maybe get some blood tests too. In the meantime, you and your boyfriend can do other things that bring you both pleasure. Hope everything works out in your favour.
My Dr told me to use coconut oil as lube. Have not tried it yet.
Can cause infection
The worst, especially if small or large abrasions occur.
Vaginal estrogen, also there are some suppositories that are over the counter and can help in the meantime. Vitamin E, there are some cheaper ones and some from Bonafide that are more expensive.
Gave me terrible yeasties.
Yikes. Well it was my OB/Gyn who told me. I’ll let him know it’s not recommended by my Reddit peeps.