Vaginal dryness

Before we get into vaginal dryness and what is happening and how to manage it, let’s do a quick recap on some basic anatomy.
The vagina is the muscular passage that connects your uterus to the vulva. The vulva is the external genital area and includes the opening to the vagina and urethra (the exit point of the urinary tract), the pubic mound, labia and clitoris.

The tissue and muscles in the vulva and vagina are heavily impacted by oestrogen – and as oestrogen levels fluctuate and eventually decline during the menopause transition, this impacts the health and structure of the tissues in this area. This can lead to a number of symptoms – and each woman may have a different experience, depending on her unique body.

Dryness: Oestrogen keeps the tissues in this area moist, flexible and healthy. As oestrogen levels decline, this can lead to the vaginal walls becoming thinner and more fragile which may cause dryness, itching and irritation. This can be quite painful, and may even cause bleeding when the delicate skin tears during penetrative sex. The external vulva area may even become sensitive to wiping after urination.
Elasticity: The flexibility of the vagina and vulva may also decline during menopause, resulting in painful sex.
Increased risk of infection: As the vagina and vulva loose their natural moisture, this can change the balance of the natural bacteria – make the area more susceptible to infections like yeast (thrush) or change the natural discharge (becoming more or less). You may also experience burning while urinating – and could become more susceptible to urinary infections.

General increases in discomfort or infections can both lead women to feeling less inclined towards sex. And when combined with a lower libido brought on by other menopause-related factors, this can lead to women withdrawing from sex altogether. Unfortunately vaginal symptoms – unlike many other menopause-related symptoms – don’t get better by themselves or over time. They require specific interventions to deal with the underlying causes.

You do not need to suffer in silence! There is help available. In addition to the tips provided below, consider speaking to your healthcare provider who can help you understand if medication may be the right solution for you.

Here are a couple of things that you can do to help manage vaginal dryness and changes during menopause.

• Lubricants: Lubricants are one of the easiest tools you can use to reduce discomfort during sex. They come in a wide range of formats (oil-based, water-based, silicone-based) to suit different needs – but try to avoid the ones that have additives for heat, or extra sensations, as they may cause irritation.
• Moisturise: Vaginal moisturisers are different to lubricants. Just like you moisturise your skin to keep it healthy, during (and after) menopause, vaginal moisturisers can help to increase moisture in the area – with all the benefits of improved vaginal health that go with it. You can try some of the commercially available vaginal moisturisers available at your local pharmacy – or you can try natural options such as organic coconut oil, organic olive oil, or Vitamin E oil. Make sure you use a high quality, unrefined organic product from a reputable brand. All three can be used for internal and external moisturising.
• Exercise: While there are a lot of weird and wonderful claims about various exercises and gadgets to help maintain a healthy vagina, we prefer those with science to back them up. Just like the rest of your body, paying attention to exercising your vagina can go a long way to maintaining good health. Consider including some of the following:
  • Kegel exercises
  • Pelvic floor physical therapy – you will need to consult your physiotherapist to work out a plan for you.
  • Yoga poses that focus on pelvic floor strength (e.g. wide-legged squat, warrior 2, cat-cow) – you could join a local yoga class or one of the many online resources to help you get started.
• Supplements: There are some carefully formulated supplements that may help with vaginal health during menopause. As with all supplements, choose a quality brand with ingredients backed up by science. Sea buckthorn oil has been proven to aid in vaginal health and may be helpful to some women.
• Vibrator or dilator: Good vaginal health is important, whether or not you are sexually active. Using a vibrator or dilator at least once a week can help maintain the muscles and tissues in the vagina. And it’s fun! (This one is useful for all ladies, whether or not you have an active sex life.)
• Consider Hormone Replacement Therapy (HRT): Many women are concerned about hormone therapy during menopause, for a variety of reasons. While you can treat vaginal dryness and irritation symptomatically, it won’t make the problem go away – only replacing the missing hormones will. So if your symptoms are severe or having a big impact on your life and relationships, then you may want to consider an HRT solution. There are HRT solutions that are designed to support vaginal health specifically and are typically applied topically to the vagina – such as creams, gels or pessaries. Speak to your healthcare provider to assess whether a vaginal oestrogen treatment may help you.

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Disclaimer: This information is for general educational purposes, and should not be used as a substitute for medical advice, diagnosis, or treatment of any health condition or problem.