Also, did you know you could insert a vitamin E capsule intravaginally for lubrication and to ease the pain of dryness? No need to break open the capsule; the pH of your body will do the job. Some of the newsletters and many of the transcripts address the use of natural progesterone creams. Always lubricate yourself before having intercourse. You can try Replens, which is made specifically for that purpose. I've used it and it's excellent and other lubricating products, such as Astroglide, Probe, Gyne-Moistrin - even Vaseline. Condoms pretreated with Nonoxynol-9 will also add some slippery enhancement. There's also cocoa butter, coconut oil, and other fruit or vegetable oils such as almond oil and apricot oil also make nice natural lubricants. Taking vitamin A orally is very helpful for dryness in general. Add some oil to your diet. Doing something as simplistic as swallowing one tablespoon of oil (Canola, olive, sunflower, soybean) daily will add lubrication to your body. Dryness, not only vaginal, is one of menopausal women's biggest offenders Doctors may not suggest these simple and very workable methods. They don't require prescriptions 
In its September issue, "Prevention" magazine rates some of the herbs and vitamins touted to relieve menopause symptoms. Black cohosh is the only compound to earn the magazine's appellation "often helpful" in relieving hot flashes, headache, vaginal dryness and more. Chasteberry, ginseng and vitamin E are rated "possibly helpful." Licorice root should be approached cautiously and dong quai is "probably not helpful," according to the magazine. There are numerous lubricating gels available on the market. Check the Web site's "Resouces" list for names of suppliers. You can check the links on the Web site (Women's Health links). You can also connect with Pete Hueseman at College Pharmacy. Pete's toll-free number is on the Resources list on the Web site at .. they also have an 800 number. Be sure to ask for Pete Hueseman, as he's been so wonderfully helpful as Power Surge's Pharmaceutical Consultant. Transcripts of his visits to Power Surge is in the Library (see link above) of the Web site.You can also find Pete's "Ask The Pharmacist" area by clicking here and asking him any quesiton you want. He's very prompt in replying. Planned Parenthood's Sex and the Mid-Life Change FAQ * After menopause, many women have increased sexual desire because they no longer worry about unintended pregnancy. On the other hand, about one-third lose some of their sex drive. Sexual desire is often diminished by experiences with perimenopause, but it is often restored when these conditions subside. Vaginal dryness and the thinning of genital tissue can lead to discomfort during sexual intercourse and masturbation. Over-the-counter, water- soluble vaginal lubricants may be helpful. Estrogen replacement creams are available by prescription. Menopause is nature's original contraceptive. But it is important to wait a full year after menopause before giving up contraceptives. Using the Pill during perimenopause may mask menopause because periodic bleeding will continue. Women who use the Pill can have their hormone levels checked to be sure that menopause has been reached. Remember: Menopause is no protection against sexually transmitted infections. Condoms are always necessary during sexual intercourse if you or your sex partner have more than one partner. KEGEL EXERCISES for better muscle tone. Kegel exercises help firm up the vaginal canal, control urine flow (for incontinence problems), tighten and relax the muscles you use to stop urination and enhance orgasm. Do at least five Kegels in a row several times a day:
- Tighten a little -- count five
- Tighten a little more -- count five
- As hard as possible -- count five
- Relax in reverse steps, counting five at each step
You'll find answers to almost every question about menopause in the reading room. Also, DHEA can help with libido/dryness. It encourages the production of Testosterone in your body, which is the primary hormone responsible for sexual libido. Read Dr. Susan Rako's transcripts in the Power Surge Library -- she's been a guest twice and is the author of .... "The Hormone Of Desire:The Truth About Testosterone, Sexuality and Menopause." You might even be interested in trying small doses of testosterone - check out the Web site I built for -- Dr. Susan Rako Even if you're not interested in testosterone, it's a pretty site to see.) You may also want to read Power Surge guest the transcript of Judith Sachs, author of many, many wonderful books, including a few about menopause -- one in particular, which will be of interest to you -- "The Healing Power of Sex." You'll find it in the Power Surge Bookstore. Also, DHEA can help with libido/dryness. It encourages the production of Testosterone in your body, which is the primary hormone responsible for sexual libido. Some other wonderful books I've recently come across: "Passion Play:Ancient Secrets for a Lifetime of Health and Happiness Through Sensational Sex" by Felice Dumas, Ph.D. Another Power Surge guest has been Sharyn Wolf, author of numerous books including, "How To Stay Lovers For Life." You can find her transcripts in the library, too. Another interesting new book is "Sex On The Brain:The Biological Differences Between Men And Women" by Pulitzer Prize winning science writer, Deborah Blum. There's an entire newsletter devoted to DHEA. Again, check the indices of the newsletters in the Reading Room. Remember, too, that DHEA has its drawbacks - possible masculinization -- deepening of voice and unwanted hair growth (I tried it and experienced the latter). Read the other transcripts as well, including those by Nancy Friday (The Power of Beauty; My Mother, Myself); Gail Sheehy (The Pause), Dr. Susan Love (Dr. Susan Love's Hormone Book); Dr. Chris Northrup (Women's Bodies, Women's Wisdom), Ann Louise Gittleman (Super Nutrition For Menopause and tons of others.. she's the former nutritional director of the Pritikin Center); Ruth Jacobowitz (150 Most Asked Questions About Midlife Sex, Love and Intimacy. She's great). Links to her books can be found on her transcripts in the Library. Check out the revised Menopause Reading List for not only excellent books for women's health/sexual related issues, but for links directly to where you can purchase most of these books online - at amazon.com View the other chat transcripts in the in the library as well. There's excellent information there which addresses your very questions, but you have to do some of the legwork yourself. I've tried to provide as much as possible for all of you. Natural Therapies to Treat Thinning Vaginal Walls The thinning of the mucos membrances, along with a loss of elasticity in the walls of the vagina, causes an uncomfortable sensation of dryness in many women during the menopause cycle. The thinning of the vaginal lining results from the ovaries' decreased production of estrogen. This thinning does not always cause problems, but it can be painful if the lining of the vagina becomes inflamed, dry, and rough. Estrogen creams and pills are the common allopathic solution for this problem, but these products have serious risks and should be used with caution and awareness. Though the medical name, atrophic vaginitis, makes this situation seem as if it is a disease, it is not. It can be remedied with simple loving care and understanding. Above all, follow a good solid nutritional program during your menopause years. This, more than anything, will help prevent the vagina from becoming overly dry and thin. * Drink at least two quarts of water and/or [herbal] tea each day. * Aloe vera/slippery elm paste is often used to soothe and lubricate an inflamed, dry vagina. Mix enough slippery elm powder into some aloe vera gel to form a thick paste. Apply inside the lips and up into the vagina. It will feel very cool and soothing. * Exercise the PC muscle (the pubococcygeus). Do Kegel exercises for this. An old friend of Power Surge, Barbara Fahs, once posted this on the boards, "I just asked Susun Weed, author of Menopause Years: The Wise Woman Way (in an online chat on AOL), what to do about vaginal dryness. She responded: Do Kegel exercises, and take tincture of Motherwort 10 drops twice a day. You can also take tincture of Dong Quai, 25 drops a day, but don't use Dong Quai if you have fibroid tumors. * Apply the following herbal salve whenever the vagina feels dry and irritated: NOTE: All herbs must be completely dry! 1 part comfrey leaf and root 1 part St. John's wort 1 part calendula Follow these steps to make an herbal salve: 1. Prepare a medicinal oil: Use a high quality seed, nut, or vegetable oil. Olive oil is a good choice. Place the herbs in a container and pour enough oil over them to cover. Then add one or two inches more of oil so that the herbs are completely submerged. Exposed herbs can introduce bacteria and spoil your oil. Place the oil/herb mixture in a double boiler, cover with a tight-fitting lid, and bring to a low simmer. Slowly heat for 1/2 to one hour, checking frequently to be sure the oil is not overheating. Oil heats very quickly, so make sure it doesn't get too hot or you'll wind up with deep-fried comfrey. 2. Cool and strain the mixture thoroughly. To strain, line a large stainless-steel strainer or potato ricer with cheesecloth or muslin. Pour the mixture through. Reserve this oil. Discard the oily herbs. 3. Then add 1/4 cup of beeswax for each cup of oil. Heat the oil and beeswax together over a very low heat until the wax is completely melted. Check for proper firmness by placing one TB. of the mixture in the freezer for a minute or two: then test the firness and adjust if necessary. If you want a harder salve, add more wax; for a softer salve, add oil. 4. When you are satisfied with the consistency, remove the mixture from the heat and immediately pour into small glass jars or tins. Seal tightly and store in a cool, dark place: it should last indefinitely. ~~~~~~~~~~~~~~~~~~~ Atrophic Vaginitis and Sexuality One of women's strongest menopause-related complaints is dyspareunia. But, unless you make a point of asking, you may never find out about it. Estrogen deficiency causes the vaginal membranes to become dry, friable, thinner, and therefore more easily irritate. Effects may include itching, burning, and pain on and after penetration. Topical strategies Any medication that causes drying of the mucous membranes can exacerbate the problem. Determine whether the patient is taking antihistamines, decongestants, or any other drug with drying potential. If possible, substitute something else or lower the dosage. Suggest a perineal wash once a day. Instruct the patient to sit well back on the toilet and rinse the vulvar region with a quart of plain water. Opening the labia gently with one hand, she should spray the water from a squirt bottle or pour it slowly from one corner of a square or rectangular container. A naturopathic agent known as tri-estrogen cream or triple estrogen cream is available from selected pharmacies, such as those specializing in holistic or women's health (see "Pharmacies that sell - and ship - natural hormone products"). Estrogens are extracted from natural sources like soy and yams and blended in a ratio of 80% estriol, 10% estradiol, and 10% estrone. Tell patients that the product does not provide protection against heart disease or osteoporosis. Applying vitamin E oil helps to hydrate the vaginal membranes. Creams or ointments from calendula (Calendula officinalis), comfrey (Symphytum officinale), or St. John's Wort (Hypericum perforatum) may decrease the vulvar or vaginal burning, itching, and other symptoms of dryness that result over time from thinning of the external skin. These products are generally applied externally once or twice a week or as needed. A more traditional route is the use of any of a number of estrogen vaginal creams (see "Nonsystemic Estrogens,"). OTC water-based vaginal lubricants, such as K-Y Jelly, are also available. One OTC product, Replens Vaginal Moisturizer, hydrates vaginal tissue for 2-3 days after a single application. Caution patients that petroleum-based products such as petrolatum or petroleum jelly can break down latex condoms, foster infections, and form a barrier against natural lubricants. Naturopathic vaginal lubricants include olive oil, wheat germ oil, sesam oil. A square quilted cotton makeup pad is soaked in any of these oils, squeezed out, and inserted in the vagina oven-light once a week or as needed.narrowing of the introitus can induce dyspareunia in women who have intercourse infrequently. Suggest to such patients that they insert a couple of fingers in the vagina during a bath or shower and gently stretch the tissues. Doing so may prevent vaginismus and pain on penetration. Regular sexual activity, including masturbation, also helps to retain normal function. Women can reduce the pain of penile thrusting by seeking sexual positions that give them more control. They can also encourage their partners to prolong foreplay to aid vaginal lubrication, which typically becomes delayed with age. The use of graded vaginal dilators may be used to prepare women to resume intercourse comfortably after a long period of abstinence. Vaginal itching may be eased with an oatmeal bath. Cooked oatmeal can be placed in a strainer and held under the tap as the tub Ms. An OTC bath product - natural colloidal oatmeal - is also available and may prove more convenient. Oral agents Ingesting yogurt products that have a high acidophilus count helps to maintain vaginal pH as the vaginal flora become altered with age. Acidophilus, which requires refrigeration, is also available in capsule form - 460 mg/d supplies the amount of acidophilus in 8 cups of yogurt. While the capsules are usually swallowed, they can also be inserted vaginally, especially for vaginal infections. Chasteberry (Vitex), taken in a tea, is said to revitalize vaginal tissue. Oral administration of dong quai, an estrogen precursor, has been reputed to enhance lubrication and relieve other menopausal symptoms. However, results from a recent study indicate that dong quai has no estrogenic effect on endometrial thickness or vaginal cells in postmenopausal women, and it's no more useful than placebo in relieving menopausal Symptoms.14 Zinc, at a dosage of 15 mg/d, is thought to revive vaginal tissue as well - wheat germ, seafood, meat, and oats are all good food sources. Evening primrose oil, a common folk treatment for symptoms of premenstrual syndrome, is said to have hormone-mediating properties. These are attributed to (Gamma)-linolenic acid, the essential ingredient. Licorice root, an estrogen precursor, and sarsaparilla, a progesterone precursor, are often used in combination for flushing. Large doses of licorice root - also known as glycyrrhiza - can on rare occasions increase blood pressure, so women with hypertension should avoid using the agent. Since decreased sexual desire tends to be of multifactorial origin, medication may not be the answer. Stress, fatigue, body image, and relationship difficulties typically play a part. Many drugs, including antidepressants, can inhibit libido. Reassure your patient that her capacity to achieve orgasm will remain physiologically unimpaired. A low-dose (2%) methyltestosterone cream applied nightly or bid over the clitoris may improve the situation without inducing masculinizing - though reversible - side effects such as facial hirsutism and deepened voice. This product must be specially compounded by a willing pharmacist. Many women take the much-touted dehydroepiandrosterone (DHEA) to heighten libido. If your patient tells you she's taking DHEA, especially in large dosages, remind her that long-term safety and efficacy are unknown and that hepatic and lipoprotein-related effects are suspected. Instruct her to take no more than 50 mg/d. Order liver function tests and lipoprotein profiles frequently, and check serum testosterone regularly. Dearest