It’s a common scenario. A woman is given a prescription for a local vaginal estrogen, or DHEA and uses it faithfully but continues to have painful intercourse. In most cases, the product is working just fine and there is another reason for the pain.   In this segment Dr. Streicher discusses: The TOP 5 REASONS women have pain despite using estrogen Why a WRONG DIAGNOSIS might be the problem The importance of treating the VESTIBULE (the opening) of the vagina Why a painful, tight PELVIC FLOOR might be the problem The role of PELVIC FLOOR PHYSICAL THERAPY  VAGINAL DILATORS- What they are, how they help, and how to use them.  Soul Source Dilators https://www.soulsource.com/ How to Find a Pelvic Floor Physical Therapist Pelvic Floor Physical therapists trained by Herman & Wallace Pelvic Rehabilitation Institute www.pelvicrehab.com  American Physical Therapy Association (APTA) Section on Women’s Health www.aptapelvichealth.org/ptlocator  For further information: Episode 3: What's Up Down There? Genital Dryness & Misbehaving Bladders Episode 4: Is Your Lubricant Helping or Hurting Your Vagina? Episode 5: Vaginal Estrogen- Rings, Creams, and Other Things  Episode 11: Vaginal Estrogen is Not Poison Episode 63 DHEA-An Estrogen Alternative for Vaginal Dryness  Episode 83 Get the Biggest Benefit from Vaginal Creams, Rings and Other Things Episode 130- Are You Ever Done with Menopause?  The Essential Guide to Hysterectomy Episode 1: Is It Menopause or Some Other Pause? Episode 23: Welcome to Peri-menopause Lauren Streicher, MD is a clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine, and the medical director of the Northwestern Medicine Center for Sexual Medicine and Menopause. She is a certified menopause practitioner of the North American Menopause Society.  Dr. Streicher is the medical correspondent for Chicago’s top-rated news program, the WGN Morning News, and has been seen on The Today Show, Good Morning America, The Oprah Winfrey Show, CNN, NPR, Dr. Radio, Nightline, Fox and Friends, The Steve Harvey Show, CBS This Morning, ABC News Now, NBCNightlyNews,20/20, and World News Tonight. She is an expert source for many magazines and serves on the medical advisory board of The Kinsey Institute, Self Magazine, and Prevention Magazine. She writes a regular column for The Ethel by AARP and Prevention Magazine.  Subscribe and Follow Dr. Streicher on  DrStreicher.com Instagram @DrStreich Twitter @DrStreicher Facebook  @DrStreicher YouTube  DrStreicherTV Books by Lauren Streicher, MD  Slip Sliding Away: Turning Back the Clock on Your Vagina-A gynecologist’s guide to eliminating post-menopause dryness and pain Hot Flash Hell: A Gynecologist's Guide to Turning Down the Heat Sex Rx- Hormones, Health, and Your Best Sex Ever The Essential Guide to Hysterectomy