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Anon,

Wow. Welcome to EmpowHer. My hat is off to you and what you have endured in the last five years. I'm so sorry that you've experienced so much discomfort, and that you lost your house in a fire on top of everything else. That's a lot to deal with.

For those who are unfamiliar with vaginal atrophy, it basically is a label for a collection of symptoms that can happen to a woman's vagina during and after perimenopause and menopause, as hormonal levels decline. Here are some symptoms, according to the Mayo Clinic:

* Vaginal dryness
* Vaginal burning
* Watery vaginal discharge
* Burning with urination
* Urgency with urination
* More urinary tract infections
* Urinary incontinence
* Light bleeding after intercourse
* Discomfort with intercourse
* Shortening and tightening of the vaginal canal

A woman may not experience all of these, but even two or three can be enough to cause severe discomfort, especially during intercourse.

Here's the Mayo's page:
http://www.mayoclinic.com/health/vaginal-atrophy/ds00770/dsection=symptoms

Anon, I am wondering exactly which symptoms you are experiencing. I understand that sex is painful, but is it because of lack of lubrication, or has your vagina undergone shortening or tightening?

I'm sure that you've used vaginal lubricants, correct? But have you tried vaginal moisturizers? They are slightly different. The Mayo mentions both Replens and K-Y Silk-E. You apply the moisturizer every two or three days and it helps restore some moisture to your vaginal area.

This page has a good discussion about lubricants, moisturizers and Vitamin E:

http://cme.medscape.com/viewarticle/561934

Are you able to allow enough time before intercourse to become aroused?

Does your doctor also want you to avoid vaginal estrogen? (A small amount still gets into your bloodstream, but much less than with oral treatments). Here is Medscape's report on research about this:

http://cme.medscape.com/viewarticle/556471

Womantowoman.com says you can find natural relief from vaginal dryness. They recommend trying the following for a few weeks:
-- Boost your water intake. They recommend 10 8-ounce glasses a day, but if you drink that much and feel like you're going to float away, just work up gradually from however much you drink now.
-- Try to use chemical-free products whenever possible, especially in consumer items like soaps, cleaners, detergents and personal grooming items. Chemicals in those products can be irritants to sensitive tissues.
-- Follow a hormone-balancing diet, considering adding flax seed or soy (be sure to ask your doctor about this in your case).
-- Take a top-quality vitamin and mineral supplement.
-- Try different lubricants and moisturizers.

Here's their home page. I don't normally recommend sites that also sell their own supplements, and I'm not suggesting you buy theirs. I included it because they have good information in addition:

http://www.womentowomen.com/understandyourbody/symptoms/vaginaldryness.aspx?id=1&campaignno=vaginaldryness&adgroup=ag2atrophy&keywords=vaginal+atrophy

And this page has several suggestions for natural treatments:

http://www.safemenopausesolutions.com/natural-menopause-remedies.html

Do you live in a city large enough that you could find a naturopath? Naturopaths are familiar with natural/alternative medicine, and they work with the body as a whole, in addition to your regular doctor. Here's the American Association of Naturopaths website; they also have a directory where you can find naturopaths in your area:

http://www.naturopathic.org/

And I realize I'm throwing a lot at you here, but this article seems terrific, and is full of suggestions:

http://www.power-surge.com/educate/sexuality.htm

I hope some of this helps. It sounds like you miss what was a loving and fulfilling sexual life, and I hope that returns with just a few adjustments in your daily life.