Many women are very comfortable talking about menopause symptoms when it comes to their hot flushes and night sweats. However, a lot are often super shy when it comes to talking about their dry vaginas! This is usually because you might be embarrassed and do not realise how common vaginal dryness is during menopause.
Reduced oestrogen levels may cause a number of changes in the vagina, including thinning of the walls, reduced elasticity, reduced blood flow and reduced lubrication (wetness).
Changes in vaginal fluid promote the growth of bad bacteria and increase the risk of both vaginal and urinary tract infections.
Vaginal symptoms as a result of these changes may include dryness, itching, discomfort and pain during or after sex. However, these symptoms may not appear until many years after the last menstrual period.
Of the vaginal menopause symptoms that occur, a lack of lubrication during sex is often one of the first to be noticed. Vaginal lubrication plays an important role during sex and women are usually expected to produce a moderate amount. You probably prefer sex to feel wetter, you may feel it is easier to orgasm when sex is wetter, and may believe that your partner prefers sex that feels more wet than dry.
Your GP can help you to find out if you are perimenopausal or menopausal depending on your age, menstrual cycle and symptoms. However, diagnosis may be more difficult if you are taking some kind of hormonal treatments (e.g. to treat heavy periods). They might need to examine you. This could include examination of your external genitals or vulva, which includes the opening of the vagina, the fleshy lips surrounding this and the clitoris. They may also examine the inside of your vagina with gloved fingers and/or a speculum (a plastic instrument which is inserted into the vagina and gently widened to allow better visual examination).
Some Other Methods:
There are many different products available and it is important that you find one that suits you. These can be prescribed by your doctor, obtained from chemists or directly online. Moisturisers are used regularly whereas lubricants are usually used during sexual intercourse.
The usual treatment is replacing the oestrogen in your vagina and the surrounding tissues. A cream, vaginal tablet or ring containing oestrogen is often prescribed and they can work really well. A vaginal tablet is a very small tablet that you insert into your vagina with a small applicator. The vaginal tablets and creams are usually used every day for two weeks, and then used twice a week thereafter. The ring is a soft, flexible ring with a centre that contains the oestrogen hormone. This ring releases a steady, low dose of oestrogen each day and it lasts for three months. It can be inserted and replaced easily by yourself, or by your nurse or doctor.
Using topical oestrogen in this way is not the same as taking HRT and therefore does not have the same risks associated with it. This is because these preparations work to restore oestrogen to your vagina and surrounding tissues without giving oestrogen to your whole body. These preparations can be safely used by most women and also can be used on a regular basis over a long period of time (usually indefinitely) as your symptoms will usually return if you stop this treatment. You may find that find using the right type and dose of HRT can really improve their symptoms.
Your symptoms should improve after about three months of treatment. You should see your doctor if your symptoms do not improve, as sometimes these symptoms can be due to other conditions. It is also very important to see your doctor if you have any unusual bleeding from your vagina if you are receiving hormone treatment.