Vaginal Pain & Dryness
Depleting hormones in perimenopause can cause irritation, itchiness, and dryness in, and around, the vagina. Medically termed as, Genitourinary Syndrome of the Menopause (GSM), or vulvovaginal menopause symptoms, this discomfort is often embarrassing, and uncomfortable, and not something many of us want to talk about.
What causes menopause vaginal pain and dryness?
One of the most common symptoms of low oestrogen in menopause is vaginal dryness. Oestrogen makes the lining of the vagina thicker, and more elastic, keeping it moist and healthy. Now depleting levels mean thinner, less elastic, drier vaginal tissue and loss of fatty tissue. Unfair! Weight loss where you’d least expect – or want - it. And yes, your vagina will look different. The soul-sapping medical name for this condition is urogenital atrophy but there’s not a trophy in sight. We think vaginal dryness is a more all-purpose description so that’s how we’re describing it.
A topic that Jane Lewis, author of ‘Me and My Menopausal Vagina’, knows far too well. Hers is an extreme case, and her book is now recommended by GPs in the know, to help their patients.
Medical menopause treatment for dry itchy vulva and vaginal atrophy
Medical help may be the best option for you if suffering a dry itchy vulva, painful intercourse, vaginal pain or dryness.
How does localised HRT reduce vaginal dryness?
Estring is a soft vaginal ring, worn for three months that slowly releases a small, localised dose of oestrogen straight to the vagina, to reduce dryness. This is an HRT product available with a doctor’s prescription. Reviews seem mixed with some women talking about weight gain and discomfort but others finding it does the job. This would be something to discuss with your doctor.
Can topical vaginal creams help vaginal dryness?
Other options to manage vaginal dryness include topical vaginal creams or capsules applied directly into the vagina - Ovestin or Vagisan oestrogen-only creams or, or localised HRT oestrogen capsules, such as Vagifem.
Symptoms will return once you stop using the ring, creams or pessaries.
(Your doctor can prescribe lubricants. If you're prone to bacterial infections or sensitive to glycerin and glycol ask for a lubricant-free from these ingredients.)
We spoke to Christien Bird, Women's Health Physiotherapist, to find out more about how we can deal with vaginal atrophy - see our video where she talks about managing painful sex.
HRT for vaginal atrophy
HRT replaces oestrogen to help with your symptoms of menopause. There are two types of HRT and the type you take will depend on where you are in your menopause, and if your periods have stopped completely for a year.
HRT taken as a tablet, patch or gel can help deal with menopause painful intercourse and vaginal dryness by restoring hormone balance. Doctors will look at your unique circumstances and whether or not HRT is appropriate for you.
The usual caveat here is that this is something to be discussed with your doctor. There are pros and cons to taking HRT. We don’t take a view. It’s for you to decide whether it’s for you or not.
Non-medical menopause treatment for vaginal dryness
The Australian Menopause Society have listed the following as helpful non-prescriptive treatments for menopause vaginal irritations:
Cool washes with a dilute solution of bicarbonate of soda (1/2 teaspoon in 1L of water) or compresses for vaginal itching and mild discomfort. Softly pat dry. Avoid scratching and keep the area cool and dry.
Polycarbophil/nonhormonal based vaginal moisturisers (Replens®) can plump up cells in the vagina, reduce vaginal symptoms and restore vaginal pH2.
Water or silicone based vaginal lubricants may reduce dyspareunia. Try YES®, or Sylk®.
Vitamin E, either orally or topically, may reduce vaginal symptoms.
Pelvic floor exercises may help symptoms of GSM.
And the good news is….
You’re not alone. There are products, professionals and other women who can help your menopausal atrophy. Taking action should go some way to resolving the problem of your vaginal pain in menopause.
Taking a closer look at your diet and what you eat may go towards improving your vaginal comfort. And if you want to take a more holistic approach, changes to your lifestyle, the products to use, or more importantly to avoid, can all help deal with your burning menopause sensations!
