Menopause and vaginal dryness

The perimenopause and menopause can affect the way your vagina looks, feels and functions. In medical terms, this is known as genitourinary syndrome of menopause (GSM). Changes to your most intimate region can leave you feeling completely out of sorts, so understanding how to tackle the specific symptoms is key. 

 

GSM can cause many different symptoms including vaginal dryness, itching, bladder issues, urinary tract infections (UTIs) and more. Unlike other menopausal symptoms such as hot flushes, vaginal health issues rarely get better of their own accord. Many women are reluctant to speak to a doctor about vaginal dryness problems due to embarrassment and social stigma, but it’s important to seek the right course of treatment, or these uncomfortable and irritating symptoms can persist. Getting over any embarrassment could make a serious difference to your life.

 

While vaginal changes do not affect all women, they are very common, and can affect the individual emotionally too. This is because vaginal dryness can detract from the enjoyment of sex, interfere with relationships and work, and have a negative effect on day-to-day life and sleep – a whole bunch of reasons to tackle the issue as early as possible!

 

Fortunately, there are medications and lifestyle changes that can be made to alleviate vaginal atrophy symptoms, allowing you to retain your comfort and self-esteem.

Every woman will experience the perimenopause and menopause differently. Some individuals may experience a range of different vaginal atrophy symptoms, while others might only experience mild discomfort for a short period of time. The following symptoms can range from mild to severe, so treatment should be adjusted accordingly.

 

The vagina’s rugal folds (the wrinkly tissue that forms the wall of the vagina) allow it to expand for sexual intercourse and childbirth. During the menopause, these rugal folds thin and flatten due to a reduction of oestrogen. The thinning of the rugal folds can cause vaginal pain and soreness, most commonly during sex.

 

Along with the thinning of the rugal folds, the menopause causes the shortening and narrowing of the vaginal canal. As such, you pay experience vaginal dryness, even when aroused. Lack of natural lubrication can make sex more difficult and painful, and can also make the vagina and vulva more susceptible to tears and injury.

 

During the perimenopause and menopause, the pelvic floor muscles can weaken, which can cause a loss of vaginal sensitivity. With less oestrogen in the body, the clitoris can also lose sensitivity, making sex less enjoyable.

 

Urinary incontinence is not a direct consequence of menopause, but many women experience issues during this time. Reduced oestrogen production can affect the quality of the mucous membranes in the genital area, which in turn may contribute to changes in the urinary tract and increased sensitivity to urgency and leakage. Women may also notice that they release small amounts of urine when coughing, sneezing, exercising, or during other activities. Kegel exercises and TENA pads can help mitigate this widespread issue.

 

Hormonal changes during the menopause can disrupt the vaginal microbiome, particularly lactobacilli, which helps keep the pH of the vagina balanced. This can result in frequent or unpleasant yeast infections. Additionally, the decline of oestrogen deficiency may be associated with lower urinary tract symptoms such as frequency, urgency, nocturia, urgency incontinence and recurrent infections.

If you are going through the perimenopause or menopause, you don’t have to simply put up with the discomfort of vaginal atrophy and its related symptoms. There are many different prescribed treatment options, home remedies and specialist products designed to alleviate menopausal side effects and support you through this time.

 

Many women choose to start Hormone Replacement Therapy (HRT) to minimise menopausal symptoms, including vaginal atrophy. You can typically begin HRT as soon as you experience menopausal symptoms, after speaking to your doctor. Your doctor will explain the different types of HRT available, and will help you choose the right treatment. You may start on a low dose, which can increase at a later stage as symptoms get more severe.

 

Easily accessible over the counter vaginal moisturisers and lubricants are generally the first remedy women try when experiencing vaginal dryness due to the menopause. You can speak to your pharmacist about the most suitable product to restore moisture to the vaginal area and reduce discomfort.

 

If over the counter products do not provide you with any relief from vaginal atrophy and you are reluctant to start HRT, your doctor may prescribe an oestrogen cream or pessary. You can apply creams topically to the vulva or insert them internally into the vagina with an applicator. If you are using a pessary, your doctor will let you know how often to insert the tablet to minimise your vaginal dryness symptoms.

 

If you experience vaginal pain and discomfort during the menopause, you might like to try using a vaginal dilator, a machine that helps stimulate and stretch the vaginal muscles. This can help reduce the narrowing of the vagina due to a reduction in oestrogen. Vaginal dilators can be especially useful for those experiencing pain during sex. These are often available without prescription.

 

Women experiencing the perimenopause and menopause should make a conscious effort to complete regular pelvic floor exercises, otherwise known as Kegel exercises. This will increase blood flow to the vagina, increase elasticity and reduce the likelihood of vagina atrophy.

 

If you experience urinary incontinence as a side effect of vaginal atrophy, there are plenty of products designed to help you live a full life free of worry and embarrassment. TENA pads can help keep you deal with urinary incontinence by keeping you protected throughout the day, ensuring you can continue doing the things you love during and after the menopause.