During the menopausal transition, the state of the vagina often changes. Vaginal dryness and pain are symptoms of vaginal atropy (atrophic vaginitis) that occur as a result of lowered estrogen levels. The tissues in the vagina weaken, get thinner, dryer, and may get inflamed, causing pain, burning, or discharge.
Changes to the vagina usually occur at the same time as changes in the urinary tract, so they have recently been combined into a single category – genitourinary syndrome of menopause (GSM). GSM covers a variety of changes to the genitourinary tract – particularly the urethra and vagina. Vaginal atrophy and urinary incontinence (UI) are the most common symptoms of GSM, affecting 40-50% of midlife and aging women.
Women may be very reluctant to speak up and act on vaginal issues due to embarrassment and negative feelings about aging. However, these are conditions that can be treated at home or with the help of a medical practitioner.
To address vaginal atrophy at home, you can:
At age 40 find a reliable, educated primary care provider familiar with recognizing and treating the symptoms of perimenopause and menopause. The North American Menopause Society provides a list of menopause practitioners here.
You can try over the counter vaginal moisturizers and lubricants to help increase the moisture in the vagina. If you are using a lubricant, which is typically applied just before intercourse and reduces vaginal pain, check to see if the product contains any petroleum (like petroleum jelly). If you are in the menopausal transition there is still a chance of pregnancy, and petroleum based products can break down latex used in condoms.
Topically (locally) applied hormone therapy (HT) with estrogen is safe and often effective for reducing dryness in the vaginal lining and improving strength of the vaginal wall. Topical HT comes in the form of creams to apply inside the vagina or tablets and rings that can be placed inside the vagina. Locally applied estrogen can also help to reduce the incidence of urinary tract infection.
Vaginas are part of a woman’s sexuality and reproduction and can be healthy throughout life.
The walls of a vagina are muscular, and with stimulation and estrogen support, can remain strong and thick. The vaginal lining secretes mucus, which makes the walls slippery. Mucus also protects against bacteria and yeast overgrowth.
The effects of menopause-related vaginal thinning and dryness can be mitigated with over-the-counter products, gentle Kegel exercises and safe and effective HT with estrogen.
Postmenopausal European women with symptoms of vaginal atrophy
Patients with vaginal atrophy who receive adequate therapy
Vaginal healthy aging can be had by using non-prescription lubes, HT with estrogen, and regular exercise with masturbation and intercourse.
No, there are many safe and effective non- prescription medications that can be used to lubricate your vagina. A vagina is a muscle, and it needs exercise.
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