Vaginal atrophy, one of the menopause’s little rewards?

It’s one thing dealing with hot flushes, mood swings and weight gain but it really doesn’t seem fair that once women make it through the menopause there are a whole heap of vaginal issues that become the next postmenopausal issue to be prepared for.

You are officially postmenopausal when your symptoms have settled down and you have been free from periods for 12 months or longer. You might be about to breathe a sign of relief but before you go putting your feet up it’s time for a heads up that you could experience some uncomfortable changes within your vagina.

Oestrogen and vaginal health

Before the menopause the female hormone oestrogen kept a close eye on vaginal health. This hormone helps keep the cells of the vagina wall healthy and lubricated. However, as levels of oestrogen tend to plummet during and after the menopause cells in the vaginal wall become thinner, dryer and damaged which sets the scene for a collection of vaginal health concerns that have been grouped under the medical term ‘vaginal atrophy’.

Tell-tale signs

All these vaginal atrophy symptoms are far more common than you might first think. Common symptoms include:

• Vaginal soreness, itching and burning
• Burning on urination
• Pain or discomfort during sexual intercourse
• Spotting after intercourse
• Slight vaginal discharge
• Frequent vaginal infections

The most common symptom is vaginal dryness which affects 50% of post-menopausal women between ages 51 and 60. So be prepared to discuss vaginal oestrogen creams with your doctor and shop for lubricants and natural water-based moisturisers for vaginal dryness. Wearing cotton underwear and avoiding irritants like soaps and chemical-based femfresh products is also advisable.

Vaginal microbiome

Just like the gut, the vagina has its own microbiome which contributes to overall vaginal health and wellbeing. Before the menopause the mucus secreted by cells in the cervix and vagina wall keeps the vagina clean, moist and fresh. This mucus also functions to keep the pH slightly acidic providing a perfect environment for a healthy vaginal microbiome to flourish. However, as vaginal cells become thinner during the menopause and as oestrogen falls less mucus is produced and the pH in the vagina changes meaning that vaginal infections, discharge and frequents UTIs could start to occur. There are some natural lubricants and vaginal pessaries that contain live bacteria such as lactobacillus acidophilus to help to re-balance the vaginal microbiome, soothe vaginal irritation and provide female freshness and comfort.

Uncomfortable sex 

After the menopause you may notice changes that could influence your willingness for love-making. Up to 25% of postmenopausal women age 50-59 experience vaginal dryness during sex because it may have become more difficult for the vagina cells to produce the extra lubrication needed for smooth intercourse. For 16% of these women, sex could become incredibly painful and may even lead to slight bleeding and a burning sensation. This can understandably be hard to talk about with your partner. However, it’s important to let your partner know what you are experiencing and to explain that it’s just part of the menopause. You may discover that your partner has been worrying that these changes may be occurring because your feelings towards them have changed, so an open discussion can be very reassuring for both of you.  

The CLOSER Study

A survey of 4100 postmenopausal women and their partners from the UK and other countries from Europe, Scandinavia, Canada and the US were asked to talk about how vaginal atrophy impacts on their intimate relationship. The study revealed that 28% of women hadn’t told their partners that they experienced vaginal discomfort due to embarrassment or thinking it was just part of getting old.

However, many of the men were more comfortable talking about vaginal atrophy than the women and 82% of males wanted their partner to share their experiences about this subject.

Don’t let vaginal atrophy put out the flame of intimacy in your relationship. Invest in some natural lubricants, talk to your partner and visit your GP to discuss ways to support postmenopausal vaginal health.