“Why do I experience pain during intimacy after hip replacement?”

Per your narrative, this may be physiologic changes with menopause. You should contact a gyn for management of most likely postmenopausal vulvo-vaginal atrophic changes.

Feeling uncomfortable and a ‘burning pain’ with intercourse are more indicative of low vaginal Estradiol and loss of elasticity. Quite likely, you were sexually active before your hip replacement and then you naturally had a break with your surgery and recovery. Your vaginal tissues have the ability to continue to self-lubricate ‘to a point’ when there is regular sexual activity. However, once there is a significant break in time, then those same vaginal tissues are no longer as active so they stop lubricating. But adding a lubricant isn’t always the answer; many times you need to get back the elasticity that was also lost; this is best done with a vaginal estradiol treatment. There are many Estradiol only vaginal creams or rings or vaginal pills or vaginal suppositories; ask your doctor which one is best for you and which one is covered by your insurance. Make certain that you get the ‘real deal’; get Estrace 0.1% or Estradiol 0.1% cream; do NOT settle for Premarin cream as this is Pregnant Mare’s Urine (where Premarin gets its name from). You can place the cream daily at night for several nights in a row to regain your vaginal tissue elasticity and vaginal health; then resume relations as before. You may only require the cream once or twice a week to maintain your elasticity but ‘prime the vagina’ for a week every night to get the tissues healthy again. If your partner is exposed to the cream, don’t panic and think he will suddenly grow man-boobs; simply have him wash off before falling asleep to avoid a prolonged exposure. Having your cream on different days from days of sexual relations is usually the better plan.

I do not think it is the hip surgery. In the question, you said you have not had intimacy in 12 months. In addition, you are 60 and post-menopausal, so what you are experiencing are the symptoms of vago al atrophy, which comes from the lack of estrogen that is one of the symptoms associated with menopause/post-menopause. So, with intercourse, it feels like sandpaper; patients will have burning due to the lack of or minimal lubrication and the loss of elasticity in the vagina. There are both hormonal and non hormonal meds and intermittent laser therapy via Monalisa.
Much luck, I hope this answered your concerns.

I will be unavailable and on Sabbatical (elective leave from practice and administrative duties) from Monday, May 18, 2020, until November 16, 2020. If you have questions regarding patient care, please call my office at 317-688-5870. If you have any administrative questions, please contact Konye Ori ( kori@iuhealth.org) or David Barrett ( dbarrett2@iuhealth.org).

Thank you,

Jeffrey

Jeffrey T. Meltzer, MD MBA
317.513.5677