Sexual Health

The Cost of Drugs to Treat Painful Sex for Women Is Becoming Prohibitive

It wasn’t all that long ago that women weren’t supposed to talk about sex, let alone after a certain age.

Thankfully this attitude is changing, but for many women who experience painful sex, it’s not changing quickly enough.

According to the North American Menopause Society, between 17% and 45% of postmenopausal women experience pain during sex

It is a condition dubbed in 2013 as genitourinary syndrome of menopause, or GSM.  And while there are medical treatments available for GSM, many women suffer in silence. Why?

One reason more women aren’t taking advantage of medications to treat GSM is that some women don’t know that painful sex is not an inevitable part of aging. And that there is treatment. As well, many are not comfortable discussing the topic of painful sex with their physicians. However, the rising cost of the medications for GSM is an even more prevalent reason that women are avoiding treatment. Some drug prices rise as time goes by, but the cost of medications that are needed to preserve life tend to stay fairly affordable. Estrogen for GSM in a variety of delivery systems doesn’t fall into this category. It’s not a life saver, so drug makers raise the prices and some insurance companies choose not to cover the costs or to demand a higher copay.

The price of estradiol, commonly prescribed for GSM, can be prohibitive, particularly for women on a budget. According to various drug provider websites, eight vaginal tablets, a two-month supply, can cost almost $200. Patches, also used twice a week, can cost almost $100 for a two-month supply. Oral tablets are less expensive, an average of $20 per month, but they are taken every day and they carry with them a higher risk of serious side effects, so they are not the first-choice treatment for GSM.

What Can Be Done About the Cost?

It’s easy for companies to hide from health issues that aren’t discussed in public. Discussing painful sex, GSM, and the high cost of treatment would help. Yet many women still blanch at the idea of talking about the condition, let alone saying the word “vagina.” Speaking to insurance companies and pushing for better coverage would also help, as would pushing pharmaceutical companies to lower their prices, but again, women are reluctant to voice their concerns. Ironically, although the cost of Viagra, the erectile dysfunction drug for men, dropped by half in 2017 when the company’s patent ran out and other companies started producing it, estrogen is already a generic drug and costs should not be so high.

Alternate Treatments

Not every woman can take estrogen. These include women with undiagnosed abnormal vaginal bleeding, a history of hormone related cancer (including breast or uterine cancer), blood clotting disorders (including deep vein thrombosis, DVT), liver disease, heart disease, or stroke. Speak with your doctor about your medical history before taking estrogen.

If you can’t or don’t want to take medication for GSM, there some alternatives you may try to make sex a more comfortable and pleasurable act again.

  • Using lubrication. Applying a non-hormonal lubricant just prior to having sex can reduce friction and discomfort. Moisturizers are applied more frequently, not just before sex, for longer-term relief from dry vaginal tissue.
  • Have sex frequently. It may sound counterintuitive to recommend having sex more frequently if it is not comfortable. However, regular stimulation can help increase blood flow and lubrication in the vagina.
  • Gentle perineal care. When bathing, cleanse your genitals with a soft, mild soap and pat gently dry. Do not use bubble baths, douches, or scented products. They can all dry the delicate tissue.

Painful Sex is Not Inevitable

As embarrassing as it may be for some women, sex is a normal, healthy part of life, no matter what your age. If you want to have sex, you should be able to. So, if you are experiencing vaginal pain or discomfort, speak with your doctor or nurse and express how this is affecting you. The more women speak out about their personal issues, the more the healthcare community will have to stop and listen.


Marijke Vroomen Durning RN has written articles, promotional material, and continuing medical education (CME) for health care professionals, as well as patient information sheets and articles for the general public. She has also co-authored several books. Her blog was chosen as one of the Top 10 Canadian Health and Fitness Blogs by SheKnows Canada and one of the Top 50 Nursing Blogs for 2015. She is the author of Just the Right Dose: Your Smart Guide to Prescription Drugs & How to Take Them Safely. To learn more about the book, please visit You can also go directly to Amazon or Kobo to purchase it. Please also visit and


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