Vaginal Atrophy in Menopause. Let’s Get The Conversation Started!

It’s no secret that I have struggled with vaginal atrophy during the roughest part of perimenopause.  I decided to be upfront and honest about it from the beginning, even if it did mean putting my vagina on the frontline.  My story is very common amongst the women in my Menopausing So Hard and without exception, every single one of us is horrified by this issue.

What is vaginal atrophy?

When your estrogen levels start to decline, the integrity of your vagina can be impacted resulting in some horrific symptoms.  For me I struggled with urinary incontinence, which I knew had to be hormonally driven, because my symptoms fluctuated around my intermittent cycle, plus I had never had any incontinence issues prior to perimenopause, even after having 2 kids.  For some women their experience can be much more severe, ranging from vaginal dryness, recurring UTI’s, thrush, painful sex, tearing and thinning of the skin.

These symptoms can leave women in agony, ruining their quality of life and ultimately struggling with mental health problems as a consequence.  

There is an assumption that “peeing your pants” is an old lady problem, but it is NOT!  It can happen at any age and it can happen if you are still getting your full cycle. It happens to women post cancer treatments, who have been forced into menopause, early-menopause and natural menopause.   It is a symptom that is often not addressed during medical appointments and it certainly isn’t discussed as a mainstream symptom of menopause. So when these things start to happen, women are blindsided.

On this week’s podcast, I interviewed Jane Lewis, who did the most extraordinary thing and wrote a book called, Me and My Menopausal Vagina.  She knew writing this book that the world would be talking about her vagina, yet she also knew that she MUST write her story.

When Jane was 45 years old and in perimenopause, she had an incident in the cinema where she became very uncomfortable and couldn’t sit down anymore, having to stand for the rest the movie, she realised something wasn’t ok.  After leading a relatively normal life, Jane’s life changed forever. Sex became a no-go, she could no longer wear tight clothes and had to go commando. She was miserable and started to struggle with associated mental health problems.  Her vaginal atrophy left her feel utterly ashamed and embarrassed.

She couldn’t understand what was wrong, her vagina had shriveled up and resembled tissue-paper. It was sore as hell and as red as a tomato. In addition to this, her old episiotomy scar had started to split open and her urinary urges increased, so that she was up during the night between 3-4 times.

She was initially misdiagnosed and therefore given the wrong treatment. And it wasn’t until she self-diagnosed herself using Doctor Google (something I do not endorse, but I know we have all done it!)  and told her GP what the problem was, that she started to get the correct treatment. It can be very embarrassing going to the doctor to talk about these things, and so many women suffer in silence and that is a terrible pity, as help is available to them.

This is a very candid and open discussion about vaginal atrophy, with a woman who has literally gone down the vagina rabbithole.  I think all women should listen to it and truly understand the struggles they may face during menopause and how they can get the correct treatment.  50-80% of women will get vaginal atrophy, yet only 7-10% will discuss this with their GP. It is also the symptom that will not go away, as do some of menopause’s other symptoms, so women must not ignore the signs.

In the podcast we discuss:

Permanent genital arousal disorder (PGAD):  which is spontaneous, persistent, unwanted and uncontrollablegenital arousal in the absence of sexual stimulation orsexual desire, and is typically not relieved by orgasm.  

Vaginal products: there are so many for sale in the supermarket and online, that women do not know the right ones to buy.  Usually these products are NOT the solution and may do more harm than good. Look for water or oil based products, with the least ingredients, that must be ph balanced.  Less is more for your vagina.

Treatments:
Pelvic floor physio: This should be the first thing you do before you buy products that are expensive and really just a band-aid for the problem.

HRT and topical estrogen cream: these treatments can drastically improve integrity of labia, vulva and vagina.

Laser treatment:  This might seem like  the lightsaber bbq solution, it is an expensive and controversial treatment, but in some cases it might help.  You can have both internal and external treatments and it allows local estrogen to work better.

What not to do!

  • Perfumes, your vagina is not designed to smell like a rose garden
  • KY Jelly dries you out, one of the worst products on the market.
  • If you a vagina that smell’s like your old aunts, get it checked out, don’t add perfume to it.
  • More you do the worst it will be, don’t fuss over it.
  • Don’t self-treat so get assessed by a professional.

Having sex

If sex is too painful or you are too tense and nervous,  then use a water-based good quality lubricant. Consider using a dialator to keep the vagina open, vibrators can do the same thing.

Talk to your sexual partner and not this topic shut-away. You must talk about this, there is a need to keep this very open. It can help ease any stresses between you and open up your options to having sex  without penetration and still remain close.

What should you do!

  • Don’t assume that your GP will correctly diagnose you, plant the seed that you may have vaginal atrophy and get the correct treatment.  It is often misdiagnosed as thrush (candida) and treated as such, this will not help your vaginal atrophy.
  • Where possible ask for a referral to a specialist gynecologist or vulva dermatologist (yes they really exist!).
  • Don’t be shy with the mirror, check out your vagina and see if it has changed, keep on top of this, or underneath!
    Take photos. I know this might sound bold and brash, but we need to stop being shy about our problems. If you have photos of the changes you have experienced, then the doctor will have the evidence in front of their eyes.

Jane’s life has changed forever, she can no longer ride a horse, bike or swim – she is just too sensitive, so her energy is now about raising awareness. Initially terrified about going public about this, leaving her feeling stressed and panicked, she now feels like she has found her purpose.  Receiving emails around the world from women and from GP’s telling her it has helped them change their practice – has made her stronger. Recently Jane was part of a campaign in the UK to raise awareness about menopause, going to Westminster to speak about her vagina, to raise awareness.

You can join Jane’s private Facebook group here!

And you can buy her book here!


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