Healthspan September 27, 2018

The menopause brings with it lots of bodily changes, especially in the vagina - with symptoms like dryness or pain during sex becoming day-to-day problems. We discuss what changes to expect and what you can do to help alleviate the discomfort. 

While every woman’s menopause experience is different, it’s better to be prepared for what’s to come.

Perimenopause is when your ovaries begin to stop producing oestrogen and menopause is when you stop producing oestrogen completely. Oestrogen is responsible for keeping the vagina lubricated, so when your body stops producing it you may experience vaginal discomfort.

Vaginal Atrophy

Meaning vaginal tissues are no longer working as normal, vaginal atrophy happens during the menopause because of a drop in oestrogen production.

The symptoms of atrophic vaginitis (or vaginal atrophy) include:

  • Thinning of the vaginal walls, including the entrance to the vagina
  • Shortening and tightening of vaginal canal
  • Vaginal dryness
  • Inflammation
  • Spotting or bleeding after sex
  • Discomfort or pain during sex

Vaginal dryness is a common side effect of menopause and, while it can be a source of embarrassment, it affects many women and shouldn’t prevent you from discussing symptoms with your doctor or partner.

Dryness can cause discomfort, loss of interest in sex, pain during sex, light bleeding following intercourse, soreness, itching or urinary tract infections. But you shouldn’t suffer unnecessarily - there are plenty of methods for helping soothe this area.

What helps with vaginal dryness?

Moisturiser
Unlike lubricant, vaginal moisturiser should be used regularly, regardless of whether you’re having sex, as it’s absorbed into the skin and lining of the vaginal walls, which helps to maintain moisture.

Lubricants
Choosing the right lubricant is tricky as you must watch out for things that could cause further irritation – whether it’s for everyday use or for sexual activity. Avoid perfumes, artificial colours or herbal extracts as these could create further discomfort. However, many over-the-counter lubricants are designed specifically for vaginal use and will ease symptoms such as dryness, itchiness, irritation and increase sexual comfort.

Dilators
These devices are used to widen the vagina and enable you to re-discover your sex life if you find that the menopause has shortened and tightened your vaginal canal.

Hormone replacement therapy
Severe symptoms may warrant the use of hormone replacement therapy (HRT). While there are many options for HRT, certain treatments are tailored for menopausal women – whether that’s combined HRT which uses oestrogen and progestogen or treatments using oestrogen on its own.

The NHS states: “Most women take combined HRT because taking oestrogen on its own can increase your risk of developing womb cancer; taking progestogen alongside minimises the risk.” 1

Tablets
The most common way of taking HRT, there are two types of pill available: oestrogen-only or combined HRT. For some, it’s the simplest way of having treatment.

Skin patches
Patches may be a more convenient option if you don’t want to take a daily tablet, there are both oestrogen-only and combined HRT patches available. Just stick them to your skin and replace every few days.

Oestrogen gel
Increasingly popular, oestrogen gel need only be applied to the skin once a day and is a convenient way of taking HRT. However - if you haven’t already had a hysterectomy – you’ll need to take progestogen to reduce your risk of womb cancer.

Vaginal oestrogen
Available in a form of cream, pessary or a ring that’s placed inside your vagina, vaginal oestrogen can be taking without progestogen. This treatment can relieve vaginal dryness, but it won’t help with other symptoms.

Sea buckthorn oil
Taken in the form of tablets or supplements, sea buckthorn oil is derived from an orange fruit that grows on sea-buckthorn shrubs and its benefits have been utilised in Chinese medicine for over a thousand years.

Sea buckthorn oil has been proven to help conquer said thinning and, for want of a better word, re-hydrate your vagina. In effect, sea buckthorn is a natural medicine that’ll help you on your way to a new lease of sex-life.

The pulp and seed of the Sea Buckthorn berries produce an oil high in omega 7 fatty acids; the oil is also rich in omega 6 and 9 fatty acids, carotenoids and tocopherols. The successful impact of sea buckthorn oil on vaginal dryness is down to its containment of fatty acids and carotenoids as these have long been known to contribute to the normal functioning of mucous membranes.

Read more on natural alternatives to HRT here.

Lifestyle changes

Clothing
Wearing loose-fitting clothing and cotton underwear can help symptoms as it improves air circulation around the genitals, making it less of an ideal environment for bad bacteria to go.

Diet
Dr Sarah Brewer says, ‘Consider adding foods into your diet that contain plant oestrogens such as soybeans or flaxseed. A 2016 study shows a reduction in vaginal dryness with the use of plant oestrogens.2 If you struggle to incorporate such ingredients, try a supplement like Menoserene’.

Exercise
Regular exercise may promote blood flow and balance hormone levels. Talk an exercise plan through with your doctor, though, as too much could contribute to vaginal dryness.

For more advice and information about the menopause, visit our Menopause Advice Centre.


References
1 NHS (2016). Types: Hormone Replacement Therapy (HRT).
2 Franco, O.H., Chowdhury, R., Troup, J., Voortman, T., Kunutsor, S., Kavousi, M., Oliver-Williams, C. and Muka, T., (2016). Use of plant-based therapies and menopausal symptoms: a systematic review and meta-analysis. . Jama, 315 (23). 

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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