What can be done about a dry vagina?

I am 65 and my wife is 49 years old. However, during sexual intercourse, my wife is too dry that in most cases, I end up with injuries on my penis. Between saliva and KY jelly, what is the best lubricant to use? Amos

Dear Amos,
At 49, a woman may already be in menopause or about to start menopause, a time when there is low production of the female hormone oestrogen, risking not only thinning of the genital tissues but also vaginal dryness making sex a scary proposition indeed. 

Saliva has always been used as a cheap and easily available lubricant but if one has oral herpes (usually it does not show symptoms yet it can still be transmitted), this can be transferred to the genitals, infecting them. Also, other oral small organisms resident in the mouth, may be transferred to the genitals, leading to infection.

Saliva is known to alter vaginal acidity (Ph) leading to other infections, including yeast (candida).
KY jelly could be a better, easily available alternative to saliva, although in some women, it may lead to yeast infection, as well and allergic reactions.

Both KY jelly and copious amounts of saliva (especially in oral sex) may affect motility of sperms and, therefore, fertility but fortunately, at 49, your wife is likely done with having children.

Your wife requires counselling about menopause to allay her sexual anxieties, which can worsen the dryness. Also, you both need to visit a gynaecologist, who may prescribe low dose oestrogen creams to ease atrophic vaginitis and a better and more available lubricant compared to KY gel or saliva.

Even in menopause, your wife requires adequate foreplay and encouragement, apart from taking adequate amounts of fluids, among others to ease the dryness.

What causes itching during one’s period?
During my period, my whole body itches. To stop this, I take cetirizine. However, are there better alternatives since cetirizine makes me too weak? Annet

Dear Annet,
It is likely that you are reacting to sanitary pads, which may be either fake or synthetic. Use of cotton sanitary pads (or even cotton itself) is likely to help stop the itching. An allergic reaction may start around the genitals and spread to other areas of the body that are not in contact with the pads.

Autoimmune progesterone dermatitis (APD) is a rare skin condition (associated with skin rash and itching) in women that recurs corresponding to periods and is said to be a response of the skin to a woman’s own hormone progesterone changes related to periods.

This, which occurs three to10 days before a period starts, may resolve two days into the period. Unfortunately, women with irregular periods may not relate the itching problem with periods.  

Treatment may require the use of antihistamines such as cetirizine or the less sedating alternatives, which can be prescribed. You should, however, avoid medications containing progesterone, including the combined oral contraceptive pill and injectaplan.

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