Private health

Q:Ever since I went through menopause, I’ve been dealing with such severe vaginal dryness that sex has become painful. I tried topical estrogen and an over-the-counter lubricant, but they didn’t help. What other remedies do you suggest?

A:You’re certainly not alone with this problem. Nearly 40 percent of women suffer from vaginal dryness after menopause. That’s because estrogen helps keep the vagina lubricated, but as levels of the hormone dwindle in menopause, it leads to thinning tissues, dryness and pain during intercourse.

Fortunately, I can recommend a few strategies that can help. First, you may want to consider a newly approved vaginal suppository called Intrarosa. Its active ingredient, prasterone—also known as dehydroepiandrosterone, or DHEA—is a hormone that’s naturally produced by the body and can be converted into estrogen to increase lubrication and reduce pain during sex. The suppository, which is inserted daily at bedtime, is available by prescription.

Adding more soy to your diet can also help. Soy contains phytoestrogens that mimic the effects of estrogen to ease symptoms. In one study, women who consumed 24 grams of soy protein a day (the amount in 1 cup of edamame or 4 cups of soy milk) reported improvements in vaginal dryness.

Finally, you mention that you’ve already tried lubricants, but if you’re like many women, you may need to test several before you find one that works for you. I always suggest using water-based products instead of those that are oil-based since the latter can increase the risk of infection and irritation. One to try: Good Clean Love Bio-Match BioNude Ultra Sensitive Personal Lubricant ($11 for 3 oz., GoodCleanLove.com).