Oxford Menopause Newsletter | Sept 21

Vaginal Dryness

So many women experience vaginal dryness associated with the perimenopause and menopause. A large proportion of these are too embarrassed to ask for help or believe it is ‘normal’ and don’t feel they can ask for help.

During the menopause and subsequently, oestrogen levels fall. This has an impact on so many different parts of our bodies and vaginal dryness is an extremely common issue. Research has shown up to 60% of women suffer with vaginal issues yet so few ask for treatment.

Vaginal dryness can impact on women both physically and emotionally and so it’s important to discuss this with your doctor and ask for advice and treatment. Symptoms include itching, irritation, soreness, bleeding and pain during sex. As a result, loss of libido, desire and inability to orgasm can also occur.

Many women find having their routine cervical smear test extremely uncomfortable too.

Please ask your doctor if this is an issue for you, it can be difficult to have a discussion about more intimate issues but this is an important part of menopause and should not be overlooked.

Why does vaginal dryness occur?

There are various medical terms used to describe vaginal dryness. Vaginal atrophy (thinning, fragility, dryness and inflammation of the vaginal wall) and genitourinary syndrome of menopause (GSM) are frequently used. The latter refers to a mix of symptoms which include vaginal dryness, urinary symptoms (frequent need to urinate, needing to pass urine at night) and urinary tract infections.

These issues occur as a result of falling levels of oestrogen, this hormone plays a key role not only in ensuring the lining of the vagina remains healthy. When oestrogen levels fall the amount of normal vaginal discharge reduces and the lining of the vagina can become thin and fragile.

What can I do to help?

Avoid irritants

Bubble bath, perfumed soaps and other scented products can aggravate the dryness of sensitive vaginal skin. Try and use just water or non-perfumed products where possible. Wearing cotton underwear can also help as man-made fabrics can increase irritation. Moisturisers designed to treat sensitive skin can help reduce soreness/irritation.

Use lubricants

Intercourse can be extremely sore and uncomfortable so using a lubricant before intercourse and also during intercourse can increase lubrication/moisture and ensure sex is less painful. There are various products on the market including YES, Sylk, Pjur, Hyalofemme, these are all available without a prescription and contain no hormones.

Vaginal hormone treatment

There are several choices of vaginal hormone treatment that women can use, these are applied directly to the vaginal area to replace the oestrogen that your body is no longer producing in abundance. There are different ways of administering these, pessaries (inserted into the vagina with an applicator), creams or vaginal rings (flexible ring inserted by you/your doctor which releases a small amount of oestrogen each day). Treatment can take a few weeks to become effective, your doctor will advise about dosing. These treatments can also be considered in women with a history of breast cancer as the dose is extremely low but always discuss this with your doctor or menopause specialist.

HRT

Hormone therapy (HRT) can also help improve vaginal dryness together with other menopausal symptoms. Some women who take HRT will also need vaginal hormone treatment to ensure their vaginal symptoms are adequately addressed.

Summary

· Vaginal dryness is really common and affects more than half of women after the menopause but also before menopause

· Vaginal symptoms can have an adverse effect on quality of life and relationships

· There are many treatments that can treat vaginal symptoms effectively

· Discuss your symptoms with your doctor and your partner

If you would like more information or wish to discuss things in more detail with one of the Menopause Specialists at Oxford Menopause please email enquiries@oxfordmenopause.com or phone 07515 560870 for an appointment