Question:

My name is Dawn. I am 57, and I’m post-menopausal. I have vaginal atrophy and have been inserting vagifem tablets. To start with, they seemed to be working, but I now find that my vagina is burning and uncomfortable most of the time. I had a posterior repair done four months ago, and have had constant problems with vaginal atrophy ever since. Can you recommend some type of vaginal cream and could I have got this problem due to the operation? I hope some other woman with the same problem can give me some advice, as I don’t seem to get much satisfaction from doctors.

Name withheld

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Answer: 

One of the things patients rarely do is say to their doctors: “I’m not happy with the treatment I am receiving.” People are intimidated by physicians and they shouldn’t be. Tell your doctor that the treatment s/he’s recommending isn’t working, that you’re sick of leaving the doctor’s office feeling like nothing’s been accomplished, and that you want a solution to your problem, not more months of uncertainty punctuated by periodic, useless checkups. This kind of confrontational approach can sometimes be easier with a new physician. You can set the stage in the very first appointment: “The reason I am here is because I was completely unhappy with the treatment I received from my last physician. I felt like s/he wasn’t solution-oriented. These are my problems and I want them solved now, not 12 months from now.”