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Physical therapy can help reduce tightness and improve muscle function. For postmenopausal women, dyspareunia may also raise concerns about aging and body image. The clinician will examine your vulva, vagina, and rectal area for redness, scarring, dryness, discharge, sores, growths, and other physical signs that might help explain your dyspareunia. Treatment often requires a multifaceted approach that includes medications, other therapies, and self-care see "Lifestyle and self-care". But discuss the pros and cons of vaginal estrogen treatment with your physician—especially if you have a history of breast cancer, since its safety in this population isn't yet clear. And communicate with your partner; speak up about what does and doesn't feel good. Few physicians specialize in vulvar problems, and few medical schools provide much training in this area.

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She or he will also want to know about your gynecologic history e. Da Capo Lifelong Books,

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The clinician will examine your vulva, vagina, and rectal area for redness, scarring, dryness, discharge, sores, growths, and other physical signs that might help explain your dyspareunia. Wear loose clothing and choose cotton underwear. Anatomy of the vulva The vulva consists of several layers that cover and protect the sexual organs and urinary opening. Not long after going through menopause, Denise Roberts not her real name began to feel severe pain during sexual intercourse with her husband. But your primary care provider or gynecologist may be able to refer you to someone with experience in treating dyspareunia. It comes in a cream applied to the vulva or in the vagina , a small tablet inserted in the vagina Vagifem , and a flexible vaginal ring worn continuously and replaced every three months Estring.

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