With the average age of menopause being 51, most of us will spend at least 1/3 of our lives beyond menopause. This is all the more reason to take care of our bodies; we still have a lot of living to do and many years of happiness after our fertility has waned.
Lower or non-existent levels of estrogen during menopause can affect your health and change your body. An estimated 40% of women experience symptoms of vaginal atrophy in their lives, but only around 25% of those women seek treatment.
But there’s no reason to just live with the condition, taking a few preventative steps now and knowing your options can help you take control of your intimate wellbeing and continue to enjoy a healthy intimate life.
What is vaginal atrophy?
Vaginal atrophy, also called atrophic vaginitis, is the thinning, drying, and inflammation of the vaginal walls. It is caused by lower levels of estrogen in the body, most often triggered by menopause, but other conditions can also result in vaginal atrophy, such as cancer treatments, surgery to remove the ovaries, as well as childbirth and breastfeeding (although those last two are temporary).
What are the symptoms?
During menopause your body gradually reduces the production of estrogen, a hormone commonly associated with females’ sexual development and function. Lower levels of estrogen cause the normal menopausal changes to the body like hot flashes, night sweats, and mood swings.
However, estrogen hormones are also responsible for maintaining vaginal pH and moisture, as wells as keeping your reproductive tissues healthy and elastic—including the vaginal wall, labia, and even the urethra of the urinary tract.
The weakening of these tissues and changes in healthy vaginal bacteria can also cause some of the following conditions:
- vaginal dryness, itching, and burning
- changes in the look or feel of the vagina, vulva, or labia
- painful sexual intercourse
- spotting or bleeding during intercourse
- increased frequency of UTIs
- increased vaginal infections due to changes in pH levels
Start Early: Treatment and Prevention
Paying attention to your intimate health is the best way to lessen the effects of reduced estrogen on your vaginal tissue. For symptoms like dryness and using a good water-based, pH-balanced feminine moisturizer can be very effective. These work by restoring much-needed moisture and rebalancing the vaginal pH to its naturally acidic level. Other preventative solutions that can also help you reduce atrophy include:
Kegel exercise can increase blood flow to the vagina, which helps keep the tissue healthy and encourage lubrication. It also helps maintain the pelvic floor muscles, which can also be weakened as we age.
Problems with incontinence or pelvic organ prolapse (when organs bulge into the vagina) are exacerbated by the low levels of estrogen during menopause, so strengthening those muscles is doubly important. On a more exciting note, Kegels also have the added benefit of increasing sensation during sex and could improve your orgasms!
Take time to learn the right technique for Kegels as almost 50% of women struggle to isolate the correct muscles for a Kegel contraction. Many women find that integrating a Kegel exerciser using biofeedback to guide you through the routine makes keeping up with exercising much easier and more effective by helping you set goals and motivating you to keep with your exercise.
Regular Sexual Activity
Regular sex, whether with a partner or solo with a personal massager, can increase blood flow to the vagina and keep the tissue healthy. It encourages vaginal elasticity and pliability, as well as stimulating lubrication. Studies show that women who are sexually active have much less vaginal atrophy than women who are not sexually active.
Intimacy and sex may change as you get older but should always be comfortable. If you experience pain or discomfort, use a water-based lubricant and give yourself more time to become aroused through foreplay or cuddling. Don’t forget, you should still be using some form of birth control until you’re sure you can’t get pregnant.
Hormone Replacement Therapy
One of the most common and effective treatments for vaginal atrophy is hormone replacement therapy using estrogen and sometimes testosterone.
This is prescribed by a doctor and can be taken either topically (locally on the vagina or vulva) or, if you also want to treat other conditions like hot flashes, night sweats or insomnia, systemically (by mouth). There are many options, including tablets, skin patches, gels, creams, nasal sprays, vaginal rings, and subcutaneous pellets.
However, hormone therapy is not without risks. There have been some links between systemic estrogen therapy and some forms of cancer.
Bio-identical and non-oral options are the safest options, but it’s best to discuss the options with your doctor to find the best treatments for you.
Keeping up with your intimate health during and after menopause doesn’t have to be much different than in any other time of your life.
Intimacy and desire do not disappear with menopause – on the contrary it often improves! So take control of your intimate fitness now and be ready for that new stage of life and sexuality.