Well it was only a matter of time before I got round to writing about the ‘V’ word, long overdue I know, but it’s hard to prioritise topics with the menopause, there are so many symptoms…this is however always on the top of my agenda when giving talks as it has to be the one topic women are less likely to talk about amongst themselves!
Vagina - just the word makes some women visibly blush — no seriously — I've been giving a friend of mine ‘vagina therapy’ so she can now say the word without blushing and hilariously has taken ‘the therapy’ a step further and into her own hands, so now finds it very amusing to send me images of contemporary vaginal art, of which there is bizarrely rather a lot — I know I couldn’t believe it either! Here are some examples...
If you would like to see more go to : https://culturacolectiva.com/art/vagina-contemporary-art/
Anyway moving on...
Why bring up vaginas in relation to the menopause…well, vagina and bladder symptoms are very common, during any stage of the menopause...peri menopause or post menopause and can cause significant distress, yet often go unreported and untreated, with women either too embarrassed to seek medical help or simply not knowing what to look out for...knowing what is normal.
So, back to why we are as a nation so ridiculously prudish about our ‘nether regions', which then has a knock on effect when something goes wrong ‘down there’! See what I mean — so easy to lapse into this sort of terminology! Admit it how many of you have names for your vaginas…one friend referred to hers as ‘Fi Fi’ years ago, which had hilarious consequences when one of my sons decided his first car would be called Fi Fi — dissolving into a fit of giggles when he told me, he found it so amusing the car has remained as Fi Fi!
I will also never look at an orchid the same way again after a friend's 80 year old mother told us that orchids always remind her of vaginas! Sorry I digress...
Being ‘terribly British” is not, however, good for the care of your vaginas ladies! When I’m giving talks and get to the ‘genitourinary’ (anything to do with genitals and the urinary side of things to you and me) part it never ceases to surprise me how many women have absolutely no idea that their vaginas and their vulval area (external) will be affected during and after this transitional period. Vaginal and urinary symptoms differ slightly from the more commonly known symptoms like hot flushes as they are classed as some of the long term symptoms, whereas the majority of the other symptoms are classed as relatively short term symptoms. So, regardless of the varying different degrees of experiences which could potentially lie ahead, we all need to start paying a bit more attention to this area of our anatomy.
I often say we should give as much care and attention to our vaginas as we do our faces...I’m serious...how much does the female population spend on cleansers, toners and moisturisers and then there’s the time spent — unbelievable! I have a theory that what we can’t see we don’t worry about or pay attention to until something goes wrong...
As we all know with any health issue prevention is better than firefighting, so …
Firstly check out your vagina — know what is normal for you — yes I am absolutely serious no-one else is going to take responsibility for your vagina or casually ask you over coffee how it is and there’s no point going on the internet they all look slightly different! So, make sure you check out the external vulval area look out for any discolouration of skin, lumps, swelling, anything which strikes you as not quite right and the only way you will get to know this is if you have a regular peak - at least once a week! I know, I know, you are going to have to contort yourself into odd positions but grab a mirror and off you go! Plus don't forget about those pelvic floor exercises. See previous post : https://www.letstalkmenopause.co.uk/pelvic-floor-advice-lead-physiotherapist-jackie-montgomery/
Ok, so what could potentially start going on when you hit the peri menopause…I thought a list to refer to would be useful, but please don’t get alarmed always remember everyone experiences these potential symptoms in different ways and to differing degrees so…you might hardly ever notice anything but then there are women who unfortunately get the kitchen sink thrown at them and suffer extraordinarily severe symptoms.
Vaginal atrophy ( thinning and reduced elasticity of vaginal tissues )
Vaginal irritation, dryness or soreness
More infections due to changes in the acidity levels of the vagina - always find out if it’s a bacterial infection or a fungal infection.
Cervical secretions are decreased leading to reduced lubrication.
Urinary problems including frequency, urgency, leakage or recurrent UTIs
Reduced sex drive / loss of libido
Intercourse can be painful, uncomfortable
Urinary and faecal incontinence
With all the above potential symptoms it's good to remember that there can be other contributing factors and always seek medical help from your primary care rather than self medicating. Only 40% women are said to be affected, personally having spoken to many women I think that percentage is higher, it just goes unreported.
A couple of ways to treat your symptoms, firstly find yourself a really good moisturising lubricant, here lies the first stumbling block for most women — let’s face it, it’s the last thing you want to go and find on the shelves of your local pharmacy, plus there is so much choice - quite bamboozling. One product I would recommend is Sylk, although as with anything, one product does not suit all, so if Sylk doesn’t work for you there are many more very good products out there.
Sylk — their moisturising lubricant is paraben free and hormonal free, in addition, the people who run Sylk are not only extremely professional but genuinely care about women's health. An established product it covers both bases of moisturising and providing lubrication should it be required. It is also prescribable on the NHS and is now available in Boots. Many women have found it an invaluable product.
If you find your vaginal symptoms are becoming more troublesome and are just not going away then you could consider having vaginal oestrogen prescribed. Replacing the oestrogen which is declining and being localised treatment so going exactly where it is needed it has high success rates and remains the best treatment for vaginal atrophy. If you are already using a moisturising lubricant this is still safe to use in conjunction with the oestrogen - hurrah!
There are different ways of administering : vaginal cream, pessaries — slow release vaginal tablets or a vaginal ring impregnated with oestrogen which is inserted and replaced after 3 months that slowly releasing oestrogen over that period of time.
The advantage of vaginal treatment is that oestrogen is delivered directly to the oestrogen depleted tissues, so localised treatment which avoids any significant systemic absorption.
The amount of oestrogen used is very low, being between 7.5 & 10 micrograms in comparison to the 1 - 2 milligrams in systemic HRT.
HRT now that is definitely a topic for another post...
Naturally treat using vaginal moisturisers / lubricants
Or medically treat using prescribed vaginal oestrogen
Or use both of the above
Don't forget to do your pelvic floor exercises
Some useful links
Women Health Concern : https://tinyurl.com/y888u6kd
Squeezy App : https://www.squeezyapp.com
Sylk : https://sylk.co.uk
Vaginal art! : http://www.artrepresent.com/flowers-of-democracy-3/