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Am Fam Physician. 2015;91(5):279a

Original article: Dyspareunia in Women

Issue date: October 1, 2014

to the editor: I appreciated this article, which discussed several options for helping women deal with this difficult issue. However, I would suggest another treatment modality for postmenopausal dyspareunia, particularly if hormonal options and ospemifene (Osphena) are contraindicated. In one small study, 90% of patients with menopausal dyspareunia reported comfortable penetration when 4% aqueous lidocaine was applied to the vulvar vestibule for three minutes before intercourse.1 I have since recommended this to patients in my own practice with good results, because lubricants alone often are not enough. I would recommend this option in patients with vaginal atrophy who are unable or unwilling to use estrogen preparations or ospemifene.

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