How to Relieve Stubborn Vaginal Atrophy & Painful Sex Safely?

Why is vaginal atrophy difficult to reverse?

Vaginal atrophy is not a disease but an aging outcome, especially an outcome of menopause. The reason is the reduction of estrogen, the female hormone. Menopause or cancer treatments, like total hysterectomy and antiestrogen therapy, reduce estrogen production. It in turn results in vaginal atrophy.

You might have seen a wheelchair-bound handicapped man with atrophied legs. Disuse causes muscle atrophy. If one day this handicapped man stands up and walk again, his legs may grow muscles back by walking exercise. Likewise, vaginal atrophy is also reversible. But it is a little different from growing back atrophied muscles.

Vaginal atrophy a result of aging. To reverse vaginal atrophy is like to reverse aging. It is an uphill battle. It is like to smooth wrinkles (atrophy of the skin) with cream. After wrinkles are already formed, it is hard to reverse.

Botox can smooth wrinkles, but it is toxic with side effects. Likewise, the female hormone estrogen can reverse vaginal atrophy. But estrogen has more serious side effects than Botox because estrogen has an increased risk for breast cancer, heart disease, stroke and, blood clots.

How to tell if my vaginal atrophy is a stubborn case?

If your vaginal atrophy is not improved after 3 months of treatment, you may have a stubborn case.

Vaginal atrophy treatment methods include:

1) Estrogen and its derivatives, like Premarin, Osphena, Intrarosa, Estrace, Vagifem, and Imvexxy.

2) Energy-based devices. These devices focus the energy to heat the tissue. The heat causes internal injuries. Injuries trigger a wound-healing response to start tissue reconstruction or rejuvenation. Examples include MonaLisa Touch, ThermiVa, and FemiLift.

3) Nutritional supplements. These include topical nourishment like using NeuEve and dietary supplements.

4) Dilation exercise. Regular dilators and magnetic dilators.

What causes vaginal atrophy difficult to treat?

The cause is unknown. Many factors may increase the risk of stubborn vaginal atrophy. These include:

1) Age. This may be the most common factor. The older a woman gets, the harder it to reverse the atrophy. For example, wrinkles are atrophy of the skin. Women develop wrinkles often after 40, but young girls put cream on the face even before 12. Why? Because if wrinkles show up, it is difficult to reverse. The best investment in beauty is to apply the cream on the face early. Likewise, the best investment in women’s love life is to apply NeuEve early. What if you are postmenopausal? Is it too old to reverse vaginal atrophy? The answer is “No.” NeuEve can still reverse it, but it may take a little longer time and you will need to use it more often. To date, the oldest woman who has benefited from using NeuEve is 88. If you are younger than 88, you are hopeful.

2) Early onset of menopause. This means that the woman’s estrogen level has been low for a long time. Vaginal atrophy might have occurred at a younger age.

3) Total hysterectomy with bilateral oophorectomy. Removal of ovaries reduces the woman’s estrogen production. Yet, adrenal glands and fat cells can still produce a low level of estrogen.

Total hysterectomy with removal of the ovaries and fallopian tubes.

4) Pelvic radiation and antiestrogen therapies for cancer. These may be the worst factors. Radiation kills cancer cells. But by collateral damage, they also injure adjacent tissue cells. Antiestrogen therapy blocks estrogen receptors or cuts estrogen productions. Drugs include Tamoxifen and aromatase inhibitors. Both therapies cause the vagina to shrink.

5) Malnutrition. Today, overnutrition is a big problem. Yet, there are still some women suffering from malnutrition. These include women on diet for weight loss, anorexia, bulimia, and picky eaters. Certain health problems may reduce a person’s appetite and desire to eat. These include depression, dementia, alcoholism, drug abuse, and mental illness. After menopause, most women are short of calcium because of insufficient uptake. Unless you take a calcium supplement, you may be suffering from calcium deficiency. Lack of sun exposure during winter may cause vitamin D deficiency. Calcium and vitamin D deficiencies contribute to vaginal dryness and atrophy.

6) Osteoporosis. After menopause, women often develop osteoporosis due to calcium deficiency. If a woman does not take calcium supplements, she may suffer from other complications. These include facial wrinkles (atrophy of skin), and vaginal atrophy. Vaginal dryness may occur, as mucus secretion requires calcium.

Image showing women at different ages and how bone growth slows down as we age
A mid-aged woman may suffer rapid bone loss and vaginal atrophy

7) Certain diseases. These include lichen sclerosus, lichen planus, lupus, Sjogren’s syndrome, and Celiac disease. These diseases may cause vaginal dryness, pain, atrophy, and inflammation. Complications include yeast infection.

Among these contributing factors, aging is the most common, but it is easy to overcome. The worst factor is pelvic radiation. Its collateral damage to the vaginal tissue has been difficult to recover. Many methods have failed. NeuEve cream and Silk suppositories are the only products showing effect. Today, doctors are recommending NeuEve to their patients who have received pelvic radiation.

How to treat stubborn vaginal atrophy safely?

Many women with stubborn vaginal atrophy are older (>60). Some had hysterectomy or are cancer survivors. Some women are previous users of estrogen and/or MonaLisa Touch but failed to find relief.

NeuEve is an estrogen alternative. It works by nutritional supplements to the atrophied vaginal lining. It is like calcium and vitamin D for bones.

Some women used estrogen or MonaLisa Touch but failed to find relief. NeuEve still can help them.

For example, a patient who received pelvic radiation suffered severe vaginal atrophy. She did not find relief after using MonaLisa Touch. But she found relief after using NeuEve Cream and Silk suppository.

Based on our customer survey, 86% of women found relief after using NeuEve for 3 months. This means that 14% might have stubborn vaginal atrophy. See the chart below:


For stubborn vaginal atrophy, it may take a little longer time and some patience for recovery. A slow healing process is normal. Even if you took estrogen (assuming it was safe), you might not find relief in 3 months. We do not recommend estrogen because of its cancer risk.

To find relief from stubborn vaginal atrophy, we do not recommend using estrogen. The reason is cancer risk. We do not recommend energy-based devices because they are costly and unsafe. FDA has issued a warning letter against using these devices. We recommend using a combination approach with safe methods:

1) NeuEve Silk formula suppositories plus the NeuEve cream.

Aging puts two stresses on the vaginal tissue. One is dryness and the other is atrophy. The NeuEve Cream is an effective product to revive dried vaginal mucus glands. The NeuEve Silk suppositories are effective for the reversal of vaginal atrophy (shrinking). The combination can help you maximize the recovery from aging effect. Using one product may help you find relief, but it may take a longer time. After you are on Silk for 1-4 months, you may move up a level to Silver to get a more rapid recovery.

2) Dietary supplements

a) One A Day Multivitamin W/Minerals Tablet. The multivitamin with minerals tablet can help prevent nutritional deficiency. Some are for women over 50. If you are not taking this pill, we recommend that you do. Even if you are taking it now, we recommend that you take extra supplements detailed as follows.

b) Calcium, magnesium, zinc, and vitamin D3+K2. These are the most important supplements that you need to take at this age. Without vitamins D3 and K2, calcium may not absorb well. Additionally, vitamin D correlates to urogenital health in older women. Calcium is essential not only for bones but also for mucus gland secretion. If osteoporosis is not managed, the mucus gland can dry out, and the vagina atrophies. The fact that you have severe vaginal dryness and atrophy indicates severe osteoporosis. Please pay special attention to this matter before getting unexpected fractures!!!!!!!!!

c) Fish oil (or flaxseed oil) for omega-3. if you do not like fish, you can take flaxseed oil pills instead. Eat a lot of fish if you like fish. Fish provides omega-3 and also collagen proteins that support your skin.

d)Sea buckthorn oil for omega-7. This helps you to revive mucus glands and keep moisture in the oral cavity, eyes, and vagina. You can find this supplement on https://www.neueve.com/sea_buckthorn

e) Collagen and/or gelatin. Collagen is a major protein in your body, and gelatin is a degraded form of collagen. Thus, they have identical nutritional values and may both improve your skin health. Due to aging, collagen synthesis reduces. A common sign is the atrophy of skin (wrinkles) and mucosa (like vaginal atrophy). Thus, supplementing collagen/gelatin can help make the atrophied vaginal lining stronger. You can take collagen powder or pills. Or, you can eat collagen in various foods, like Jello, Gummy bear, pork rind, or vegan collagen. For enough supplement, it is important to keep the smallest daily dosage of 2.5-15 grams of collagen/gelatin.

3) Dilation exercise

To grow back the atrophied vaginal tissue, you can use dilators. NeuEve works by providing nutrients to the shrinking tissue to help it to grow back. But, if you do not exercise, the atrophied tissue may grow back slowly. To speed up the tissue recovery, doing dilator exercise helps. You must start using a smaller sized dilator. Move up the size gradually and one size at a time. You may need to allow 2-3 weeks or longer time for each sized dilator. Once you move up to the largest dilator without pain, your recovery will complete. You will have no more painful sex.

It is understandable that one may wish to move up the sizes quickly or to try the largest sized dilator first to get a more rapid recovery. However, recovery of vaginal atrophy is a slow process. Moving up the dilator sizes too quickly or skipping sizes can cause overstretching injuries and may be counterproductive. Please do not skip the sizes and try the largest dilator first. Please be patient and do the exercise with a stepwise increment to avoid possible overstretching injuries.

Physically, dilation exercise is like sexual intercourse. The penetration movement can mobilize bacteria normally on the skin into the bladder to cause UTI. You will need to pee immediately after each exercise to prevent UTI. Urination can flush out any bacteria that entered the bladder during the dilation exercise. Therefore, drinking a lot of water before exercise helps build up the urinating flushing pressure and prevent UTI.

You can find a set of vaginal dilators from our website:  www.neueve.com/dilators. You need to start from the smallest size and move up one size at a time. You can do 20 minutes of exercise twice per day. We recommend magnetic dilators. The magnet may promote local blood circulation and help regrow the atrophied tissue. This dilation exercise helps you grow collagen and elastic fibers within the tissue.

Dilators are not our products. You can click the yellow “Learn More” button to reach the VuvaTech website and learn more.

4) Cough expectorant. 

Take the Mucinex 1 pill before bedtime even if you do not have a cough.  It helps your dried mucus glands in the vagina to secrete mucus, not just in the respiratory tract. Buy the Mucinex that has only expectorant, not cough suppressant. You can get it from Amazon or your local drug store. See the image below:


You only need to use it for a few weeks. You can stop using it after you see vaginal secretion and good moisture.

For more information about how to help NeuEve to work better, please visit www.neueve.com/faq.

If you can do the four things as suggested above, you will find relief soon.

smiling couple
Relieve stubborn painful sex with NeuEve

Disclaimer: This article is for information purposes only. It is about natural products, nutrients, and/or methods for managing aging-related discomforts (not diseases). It is not medical advice for the treatment of any diseases.


Customers’ review on stubborn vaginal atrophy

A Lifesaver!!

By Valerie. Reviewed in the United States on July 10, 2021

I was using a vaginal estrogen cream after I went through menopause, and it was working fine. However, I developed breast cancer last year, and am now taking an estrogen blocker. I had no idea the problems this would cause me. It became impossible for me to have intercourse because of extreme (and I mean very extreme!) pain. Nothing my doctor recommended was helping, and I did not want to go back on the estrogen cream. I found this product doing research online, and decided with hesitancy to give it a try. I am amazed at how much better I feel! It took 3 months, and now I feel back to normal. I highly recommend this product!

Allison Watson5.0 out of 5 stars ordered for mother in lawReviewed in the United States on August 20, 2020Verified Purchase

I ordered these for my mother in law and this is what she has to say:

“My urologist told me to get these! I was having constant UTI’s for the past few years, I’m 58 and after being diagnosed with breast cancer at 49 and then being told to have my ovaries removed I had everything was taken out except my VA after that it was much too painful for any of that kind of fun! I do believe in miracles and maybe your product will make it possible again!!! Your product has made me feel so much better! I don’t have the horrible feeling of am I getting a UTI anymore or any dryness and not one UTI since I started!!! Which is huge!!! So thank you for caring enough for women’s health to make such a wonderful product!!! This is such a hard subject to discuss no one talks about it and not something I normally would but I think I need to tell you it’s working so far! The price is expensive but I will just have to save somewhere else!!! It’s been about 6 weeks since I started and I can feel the walls of my VA are starting to soften which had hardened ( I’ve even had surgery to clip scar tissue that was like rings actually closing my VA). I didn’t even know if I could get one of your suppositories in!!! But had no problems!!! I felt I needed to write this because it’s the first thing that’s worked!!! I’m not sure I would have tried this because of the price if my doctor hadn’t told me to, I think if you were to give some samples to doctors so more women could try them more women would be using them even if they tried them once they could see how they could change their lives too!!! Please know you really are helping women like me and I just have to say Thank you again!!!”

“This suppository is fantastic! I have had all the symptoms of menopause: dry, odor, and sexual pain. I have not had sex with my husband for years. The doctor prescribed vaginal estrogen suppositories, but they did not work for me. I used only 3 NeuEve’s suppositories and all my issues are gone. I feel great and can enjoy sex again. It has really saved my marriage.”

“I am 35 and am healing from an Auto immune disorder. Along with Autoimmune came fertility issues. Vaginal Atrophy and low estrogen being one of them. I cannot use hormone related products to help with the Atrophy, the hormones make my Thyroid levels drop immediately. So I researched and researched, until I found this amazing product!!!! yay!!! My husband and I can have sex again. We are seeing significant success after just 2 applications of the silk line. I plan on going through the whole line up to GOLD!!! Can’t thank this amazing company enough!!!! I love y’all!”

“I have been using the silver along with the cream…I love it! This has helped me more than anything that I have ever tried. I am switching to the gold in hopes that I will only have to use once per week. I will switch back to silver if it doesn’t work for me…..I had a hysterectomy nearly 20 years ago and have suffered from atrophy, BV, burning and itching associated with dryness. This all went away after one use!…I have tried vaginal estrogen, lubricants, vitamin E and nothing has helped until now. NeuEve is amazing…I cannot thank you enough!”

“Trust Me! This Really Works! I suffered from mild dryness and BV ever since I turned 50 now I’m 52. Estrogen patches and pills did not work for me but I was determined to find something since I am in a loving relationship with a 34 year old man! (need I say anymore…) I found this product 2 months ago and started with the silver since I was not having painful sex. I immediately noticed feeling lubricated from the inside out and I stayed that way for 5 days. Sex is beyond amazing and we make love twice a day sometimes more! So I decided to order the gold formula and had trouble receiving my package in fact I didn’t receive it. I called NeuEve customer service and who answers the phone? Dr. Chang herself the founder of this amazing product! She helped me track my product and when I still didn’t receive it she shipped me more free of charge. She also sent me a personal Email to check on me a few days ago to make sure I received it! Change your life and try this product as a nurse of 28 years, I have never experienced such a transformation ever!”

“I was really skeptical at first. I didn’t want to spend this much money and then if it did not work. But I was desperate. The doctors’ estrogen creams did not work anymore. I tried the hormone pellets and they worked great for about 4 years then it started back again. Nothing seemed to help. I was using the hormone cream daily and still no relief.
I went ahead and ordered the Gold. I wanted the strongest one. To my surprise, by the third day all my symptoms were gone! I have used the product for 3 weeks now and am about to reorder. I use it once a week and the dryness, the itching and the odor are gone! The only thing of course I wish the cost was less or they offered a discount if you got on autoship or bought a larger quantity.”

“I have used Neueve silk suppositories and cream for 2 months now and it has worked great! In the past I have been on every estrogen product available with little relief. I finally have a sex life after 2 years and I am only 57 Thanks Dr. Chang another marriage saved.”

About the author

Dr. Renjie Chang's medical and pharmaceutical experience:
- OB-GYN in the Peking Union Hospital in China
- a faculty member of OB-GYN at University of Oklahoma Health Sciences Center
- drug developer at the Abbott Laboratories in Chicago
- Founder of Lavax, Inc, where she developed an innovative vaginal microbicide for preventing sexually transmitted disease with grants from NIH and Gates Foundation
- Founder of NeuEve, an all-natural women's health company

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