There are some menopause symptoms we talk about quite openly – hot flushes, night sweats, brain fog and mood changes, for example. But there are others that can feel much more difficult to talk about.
Vaginal dryness, itching, soreness and discomfort are definitely in that category.
Yet these symptoms can be very common during perimenopause and menopause, and importantly, they aren’t something you simply have to put up with.
So, what’s actually happening?
As oestrogen levels change and eventually decline during menopause, this can affect much more than our periods and hot flushes.
Oestrogen receptors are found throughout the vulva, vagina and urinary tract. As oestrogen levels fall, the tissues in these areas can become thinner, drier and less elastic. The vagina can also produce less natural lubrication at this time.
You may notice dryness, itching, irritation or burning and some women experience discomfort or pain during sex.
For others, the symptoms can affect everyday life – perhaps sitting for long periods becomes uncomfortable, exercise feels different, or even wearing certain underwear or clothing causes irritation.
And it doesn’t always stop there. Menopause-related changes can also affect the urinary system, with some women experiencing increased urgency or frequency, or becoming more prone to urinary tract infections.
It’s more than just “dryness”
You may have heard the term vaginal atrophy, but healthcare professionals increasingly use the term Genitourinary Syndrome of Menopause (GSM).
It sounds rather technical, but essentially it recognises that the effects of declining oestrogen can involve the genital and urinary areas, rather than simply being a problem with vaginal dryness.
And this is important because these symptoms can be gradual.
You might initially think, “I’m just a little uncomfortable” or “That’s probably just part of getting older.”
But if symptoms are affecting your comfort, confidence, relationships or quality of life, they’re worth talking about.
So, what can help?
The good news is that there are several options.
Vaginal moisturisers can help with ongoing dryness and are designed to be used regularly to improve comfort.
Lubricants can be particularly useful during sex, helping to reduce friction and discomfort.
For women experiencing more persistent symptoms, local vaginal oestrogen may be an option. This is oestrogen used directly in the vagina and is available in different forms, including creams, pessaries/tablets and vaginal rings. It can help improve the health and moisture of the vaginal tissues and relieve symptoms.
Your GP, practice nurse, pharmacist or menopause specialist can talk through the options and help you find something appropriate for you.
And if you’ve tried something that hasn’t helped, that doesn’t mean you simply have to accept the symptoms. There may be another option worth exploring.
Let’s stop suffering in silence
Perhaps the biggest problem is that we’re simply not talking about this enough.
Many women feel embarrassed mentioning vaginal or urinary symptoms, even to their GP. Others don’t realise that what they’re experiencing could be related to menopause.
But there really shouldn’t be any shame attached to it.
Menopause can affect our bodies in so many different ways, and vaginal and urinary changes are simply another part of that picture.
So, if you’re experiencing dryness, itching, burning, soreness, discomfort during sex or changes in your urinary health, please don’t feel that you just have to put up with it.
We all deserve to feel comfortable in our own body.
Sometimes, the first step is simply having the confidence to say:
“This is happening to me. Is there something I can do about it?”
And the answer is very often yes.
As always, this information is for general awareness and isn’t a substitute for individual medical advice. If you’re experiencing new, persistent or troublesome symptoms, speak to your GP, practice nurse, pharmacist or menopause specialist. Vaginal or urinary symptoms can have causes other than menopause, so it’s important to get them checked if you’re unsure.
