Aunt Vadge: constant split in vulva during sex

Dear Aunt Vadge, 

Can’t have sex because vulva tears in one spot. I use BHRT estrogen cream 3 x a week in vagina.  Nothing helps. 

Yours,
Split
Age: 73
Country/Area: USA

Dear Split,

There are a few things you can do to help your vulva to not only heal, but for the tissue to become stronger as you age. Your low oestrogen may not be the only solution to your vagina woes. The combination of suggestions below may provide some relief.

   Adding testosterone to your oestrogen cream
Testosterone is part of a healthy vagina as well as oestrogen, as it strengthens the deeper layers. You could ask your doctor to prescribe a combination of oestrogen and testosterone in your cream and see if that helps strengthen your vulvar tissue further, combined. The cream usually as a 0.1% testosterone component, with oestradiol 0.01%, in a base cream, which is compounded at a compounding pharmacy. You’ll need to get advice from your doctor, however, because you need to ensure your safety when using oestrogen products of any kind.

     Are you getting everything your body needs to build strong skin?
Your skin has structural components to it that, as you age, deteriorate somewhat. The elasticity of skin is reduced due to a reduction in hyaluronic acid, collagen and elastin, so repeated tearing in older women, with wounds taking longer than ever to heal, can be a constant issue.

If you have the means, it would be really useful to get some dietary advice and personalised recommendations on tissue-strengthening from a naturopath. As we age, our digestive system becomes less efficient too, so the nutrients we absorb from food are fewer. This might mean that some digestive support could be just the ticket, to provide deeper stimulation so that your nutrients get from your digestive tract into your blood, and are distributed to the right tissues.

There will be some simple signs that a qualified naturopath will be able to spot immediately in terms of what nutrients you may be missing, which contribute directly to healthy, strong skin.

  1. Zinc (signs of deficiency include diminished sense of taste and smell, slow healing wounds, lowered immunity)
  2. Protein (signs of deficiency include flaky, soft nails)
  3. Digestive upsets that may indicate lowered digestive capabilities (signs include burping, bloating, gas)

     Use of near-infrared (NIR) light
Near-infrared is a really interesting treatment that is pretty inexpensive, and because the issue is vulvar, you can use infrared light treatments from the outside. Infrared treatments stimulate the skin cells, causing the mitochondria – the little energy factory in each cell – to pump up its energy production. This increase in energy provides the cell with more energy to do whatever it does best, and in this case, your skin will become stronger and ‘fitter’.

You can buy the near-infrared lights online (make sure they specify near-infrared, not far-infrared, which won’t do anything), and they are often combined as a heat lamp, which brings blood and nutrients to the area.

Use the light for seven minutes every 2-3 days ongoing – more is not better when it comes to light therapy, as there is a sweet spot of regularity that your body responds to. Too much and your mitochondria stop being stimulated. Not enough and it won’t do much. Just keep up this routine as often as you need to, remembering that light therapy takes time to work – your cells will be stimulated, but they have to then produce the extra energy, and then bump up collagen production. This takes time, over weeks.

You can also use this treatment on other areas of your body that may need a boost, like a sprained ankle or arthritis. It works for any area on the body (that it can reach through to) that needs stimulating. Check it out online – there is plenty of excellent research into infrared and injuries. It’s pretty great.

     Taking CoQ10 with or without your near-infrared treatments
At the same time, you could take a CoQ10 supplement, with CoQ10 being a critical nutrient for your mitochondria to produce energy. Increased energy means faster healing and less splitting in future due to stronger tissue.

There are many things you can do to increase the performance of your tissue, but not all of them will work for you, so hunt around and keep trying.

Write anytime!

Warmest regards,
Aunt Vadge

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica Lloyd - Naturopathic Practitioner, BHSc(N)

Jessica is a degree-qualified naturopath (BHSc) specialising in vulvovaginal health and disease, based in Melbourne, Australia.

Jessica is the owner and lead naturopath of My Vagina, and is a member of the:

  • International Society for the Study of Vulvovaginal Disease (ISSVD)
  • International Society for the Study of Women's Sexual Health (ISSWSH)
  • National Vulvodynia Association (NVA) Australia
  • New Zealand Vulvovaginal Society (ANZVS)
  • Australian Traditional Medicine Society (ATMS)
Read more about Jessica and My Vagina's origin story.