Advise a multimodal approach Additional strategies: 1) Vaginal dilator therapy. Additional visits outside of follow-ups may improve adherence 2) Vaginal moisturizers - Replens, Vitamin E oil, etc. This is outside of water-based lubricants during sexual activity 3) Topical estrogens (many of thes...

I agree with the above. In addition to lubricants, a hyaluronic acid moisturizer nightly both internally and on external tissues has some data for improvement of dryness and urinary complaints (hyalogyn can be ordered online without prescription).

Vaginal dilators are excellent with some good advice: use lubricants to insert. Do them once a week. Be sure they reach the vaginal vault. Be sure you keep the inside presurre pushing in with your finger for around 10 minutes.See patients once every six weeks until you are sure the vagina keeps open...

We agree with the above comments. The most common recommendation is 2-3 times a week for 10 min. I think the first year is the most important for improving vaginal function. How long do you usually recommend to use dilator?