Can you guess the least talked-about symptom of menopause? Many women don’t even tell their partners or healthcare providers about it: Vaginal dryness and discomfort. About half of all postmenopausal women in the US have vulvovaginal symptoms, including uncomfortable dryness, frequent urinary tract infections (UTI’s], and pain during sex. All these symptoms can be related to the changes your body goes through during the menopausal transition. And unlike hot flashes, which start early in the transition and eventually resolve or become much less frequent over time, vaginal symptoms appear later and will likely worsen without treatment.
Your vagina has an outer opening (the introitus) and an inner one (the barrel) that connects the outer opening to your cervix and uterus. (The walls of the barrel are what you feel when you insert a finger through the introitus.) When you’re young, estrogen keeps the walls moist and elastic. As you age, because your ovaries produce less estrogen, the tissues in your vagina become thin, dry, and less elastic. This is called vulvovaginal atrophy [VVA].
So it’s normal if your vagina and the area around it (your vulva) feel dry, irritated, and sometimes sting or burn. You may even occasionally bleed a little. Also normal: Maybe you have pain when you urinate or you’ve been getting frequent vaginal or urinary tract infections. Though you may enjoy sex, when you’re aroused, you don’t get as wet as you used to.
All of these changes can stem from lower estrogen levels. The hormone also affects the pH of your vagina, making it less acidic, and as a result more vulnerable to overgrowth of bacteria and yeast. (That’s another reason for increased vaginal and urinary tract infections.)
Enough with the grim news. Here’s what you can do. First, talk with your health care provider to confirm that there are no other medical reasons for your complaints. You can treat mild or moderate symptoms with vaginal moisturizers and lubricants. Use a moisturizer every few days to help hydrate the tissues; use a lubricant before intercourse to make penetration easier.
So if you’re uncomfortable, don’t suffer in silence. Speak up, get help…and feel better!
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