Q: Can I feel again?
A: You say that genital sensation is diminished, and you're hoping for a surgical "fix." You also experience some dryness and wonder whether that "fix" could also affect lubrication. You're also weighing the potential benefits of hormones.
There aren't surgical options to restore genital sensation. The "vaginal rejuvenation" approaches have no clinical data yet to support their benefit. I was on a phone call just recently with about 15 providers from across the country, discussing the topic of "vagina rejuvenation." There are now some very difficult complications that have come from some of these treatments.
I would caution you on this; we just don't have enough good information to say it is a safe and effective option. While I absolutely empathize with your desire for a quick and lasting "fix," unfortunately that just isn't likely given available options.
Hormone therapy absolutely improves loss of sensation. The genitals have more estrogen receptors than any other area of the body, which means that the impact of estrogen is greater in the genitals than in any other area of the body! Especially in menopause (or other times of low estrogen), hormones (including testosterone) are a big ingredient of sexual function.
Exercise is a critical component of overall wellness (see this blog post on the topic). Exercise improves energy and self-esteem, releases helpful hormones and does more that translates into improved sexual health and function.
Loss of sensation is a natural part of aging, as well as of chronic diseases like heart disease or diabetes; it can be a side effect of medications. The changes that lead to the loss of sensation happen over years.
That means for each individual, countering that loss is a bit more complex than a single simple answer that works for everyone. For many women, vibrators work wonderfully to heighten sensation. Trying a warming or arousal lubricant might be helpful now that your genital tissues are healthy.
I hope this is helpful.
Barb DePree, MD, has been a gynecologist for 30 years, specializing in menopause care for the past 10. Dr. DePree was named the Certified Menopause Practitioner of the Year in 2013 by the North American Menopause Society. The award particularly recognized the outreach, communication and education she does through MiddlesexMD, a website she founded and where this blog first appeared. She also is director of the Women's Midlife Services at Holland Hospital, Holland, Michigan.