This is a frequent concern for women as they can experience the double whammy of lowered libido and increasingly difficult sex as the vagina’s natural lubrication and elasticity is reduced as the hormones shift at menopause.

You may experience discomfort and pain which can last for several hours after sex and this is often more intense on the days just before and during a period.

The first thing to remember is that you are not alone. One study in the journal Menopause in 2008 reported that 40 per cent of women suffer, but really we have no accurate idea as many are too embarrassed to consult their doctor about it, or seek other help.

Physical causes

Initially it is best to consult your doctor to eliminate the following:

* illness or infection
* fibroids
* endometriosis
* a coil that has slipped
* vaginal atrophy or thinning of the vaginal lining
* pain from scar tissue from a tear from an episiotomy in childbirth
* constipation or a bout of irritable bowel syndrome (IBS)
* irritation or allergy caused by soaps and shampoo

The problem of course is not just physical as stress and relationship difficulties can certainly affect your attitude and physical response.

Communication is essential to discuss the issue and find solutions to help overcome any difficulty.

Natural help

If you have eliminated any medical cause, but simply may need a little additional lubrication to help with dryness, then you can apply 20 to one.

This is a bioidentical combination cream applied vaginally to help restore your hormone balance.

As the oestrogen it contains is naturally balanced by progesterone, and is very low in the dosage overall, there is no concern over oestrogen dominance.

If the issue is not just dryness but atrophy then the oestrogen content in 20 to one is not sufficient, but can be used after Wellsprings separate oestrogen cream is used initially.

Oestrogen is always best balanced with progesterone so either Serenity or 20-1 can also be used alongside it.

If you do not need any additional oestrogen then you may find that a natural lubricant that is both organic and water based can also be effective, but generally some additional hormone help is needed.

Helpful information:

Because women are often reluctant to talk about this, they do often suffer in silence but there really is no need as help is readily available.

If low libido is also an issue then the following article will be useful:

https://anna.blog.wellsprings-health.com/are-any-of-these-killing-your-sex-drive/