MenoLabs News | Tue, Jun 13, 2023

In the past, it was considered “impolite” to talk about the changes that the hormonal shifts of menopause created within our bodies. But we’re done with the whole “suffering in silence” thing. It’s time to talk about it all — including how hormones affect our vaginal health.

Estrogen fluctuations that occur during menopause produce changes in a number of different parts of the body — including the vagina, vulva, pelvic floor, and urinary system. These changes can lead to symptoms from pain to dryness — basically,  the gamut of ways to feel uncomfortable down there.

Here are some of the possible vaginal health complications that may occur during menopause, and what you can do to find relief.

Vaginal Atrophy and Dryness

Estrogen production drops during menopause, sending a signal to your body that says “Hey, we’re not so focused on the reproductive bits anymore.” Your body then effectively reroutes its energy to other bodily systems.

Because of this, your vaginal area experiences less blood flow and, in turn, does not produce the same amount of lubrication that it once did. Over time, the skin also becomes thinner, more delicate, and more prone to vaginal dryness.

However, that doesn’t mean you’re no longer able to feel aroused or experience pleasure. In fact, regularly enjoying sexual activity helps promote blood flow to the area and keeps the skin more supple. Since your body isn’t producing much moisture in that area anymore, adding both a lubricant and vaginal moisturizer to your self-care routine during menopause can also help make sex more comfortable, preventing dryness and reducing friction.

Vulvodynia 

The vulva is often mislabeled as the vagina, but it’s actually the outside area that surrounds the vaginal opening and includes the clitoris and labia. Experiencing persistent pain in the vulva, also known as vulvodynia, is a common result of vaginal atrophy and dryness. The pain may feel like stinging, burning, or soreness and may come and go with or without provocation.

If you experience persistent vulva pain, try to track when you experience it, what it feels like, and any triggers you can identify to relay to your doctor. Recent research shows comorbidity of vulvodynia and other chronic pain conditions such as fibromyalgia, interstitial cystitis, and irritable bowel syndrome, so bringing your vulva pain to your doctor’s attention may help them catch on to a serious underlying problem.

Incontinence & UTIs

The hormonal changes of menopause have an impact on your urinary system, too. Just as they contribute to the thinning of vaginal skin, drops in estrogen also thin the lining of the urethra, as well as weaken pelvic muscles. For many women, this leads to issues with incontinence and an increased risk of developing urinary tract infections.

• Overactive bladder syndrome is characterized by strong and sudden urges to urinate, an inability to hold urine in long enough to reach a toilet, waking up in the night because you need to pee, and needing to pee more than eight times in a 24-hour period. Women struggling with overactive bladder can make lifestyle adjustments including bladder control exercises and timed voids to strengthen the urinary system and prevent episodes. Doctors can help women with overactive bladders with prescriptions, nerve stimulation sessions, and even Botox.
• Stress incontinence is characterized by leakage of urine when coughing, laughing, sneezing, or lifting heavy objects. It is the most common type of incontinence, affecting about 1 in every 3 women at some point in their lives. You can help manage stress incontinence with the same techniques used for overactive bladder, including pelvic floor muscle training and scheduled urination. Doctors can help treat recurring stress incontinence with a vaginal pessary or urethral bulking agent injections.
• Urinary tract infections become a greater risk after menopause, due to both changes that occur within the urethral tissue, and the disruptions to the body’s microbiome. Drinking plenty of water, regularly emptying your bladder, and having a post-sex hygiene routine all help prevent UTIs. However, if you get one, don’t try to treat it on your own. See your doctor as soon as you experience symptoms in order to get an antibiotic prescription. An untreated UTI can lead to urosepsis, the systemic inflammatory response to urinary infection that can lead to multi-organ dysfunction, failure, and even death.

Yeast Infections & Bacterial Vaginosis

As hormone levels fall and the body’s microbiome is compromised, women in the menopause transition become more susceptible to yeast infections and bacterial vaginosis. The risks are even higher if you’re experiencing incontinence issues, as they can create increased moisture and bacterial imbalances. The symptoms of yeast infections and bacterial vaginosis are often interchangeable but considering that one is a fungal infection while the other’s bacterial, the treatments are very different. That’s why it’s important to consult your doctor; they can perform the necessary tests to determine which you may have and provide the appropriate treatment based on the results.

Ways you can prevent both yeast infections and bacterial vaginosis include:

• Never douche. Your vagina doesn’t need the extra help cleaning itself and douching only introduces possible irritants that can lead to overgrowth and infection.
• Wear loose, breathable clothing and cotton underwear. Tight clothes and synthetic fabrics trap moisture, fungi, and bacteria, creating an optimal environment for infection.
• Eat a diet low in simple sugars and high in probiotics. Yeasts feed on simple sugars, so eating them only in moderation can keep the microorganisms’ populations in check. Probiotics introduce “good” bacteria into the body to promote health and prevent the overgrowth and infection caused by “bad” bacteria.

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Menopause-related vaginal health issues can be painful, annoying, and even embarrassing. However, most of us will deal with at least one of the problems listed above during our transition. Being open and honest about our experiences can do more than ensure that we get proper care; it can also help embolden other women to take notice of their own and get the help they need.