Vaginal Dryness at Menopause
Vaginal dryness is when your vagina is less lubricated than normal for you. It is so common at menopause that at least 50% of women will suffer with it BUT not many women want to discuss this problem that can have a devastating impact of a woman’s self esteem, sex life and general health.
Changes in hormones at menopause can cause the lining of the vagina to thin (vaginal atrophy) and become less elastic or flexible. This thinning means there are less cells available to produce secretions and moisture to keep your vagina well lubricated. The change in the elasticity of your vagina means that area can shrink and change shape (shortening and tightening of the area). Both of these factors can lead to painful sex.
Menopause is often blamed for every symptom a woman of a certain age gets BUT there are a number of other reasons that can cause vaginal dryness at menopause that are not menopause related and these should be considered to make sure that you are getting the correct treatment for your symptoms.
These including:
Immune disorders
High levels of stress
Smoking
Depression
Lack of libido (hormonal/psychological)
Insufficient arousal
Some medications or cancer treatments (e.g. antihistamines, asthma medications)
Personal care products causing irritation (washes/soaps etc) or other irritants (fabrics, washing powders)
There are a number of other symptoms linked to vaginal dryness. These include a sore and itchy vagina, pain during sex and needing to pee more often than usual.
Vaginal dryness can make everyday things like walking and exercise uncomfortable if not dealt with.
If you are taking HRT and are still suffering from vaginal dryness it would be worth discussing this with your GP or health practitioner. There are a number of forms of HRT and something else might be more suitable for you e.g. vaginal oestrogen.
Other symptoms linked with Vaginal Atrophy and Vaginal Dryness
Vaginal atrophy can lead to increased chances of UTI’s, vaginal infections and problems with urinary incontinence.
It is always worth having a medical examination to better understand what is happening and rule out other conditions such as lichen sclerosus, lichen planus or vulvodynia and to make sure any infections are appropriately treated.
How nutritional therapy can help
Nutritional therapy will look at you and your health history as a whole getting to the root cause of your symptoms. Then targeted nutrition and lifestyle support will be given so that you can optimize key nutrients to support you to reach optimal health and combat your symptoms.
There are some simple changes you can make to your diet to support with vaginal dryness and general skin health. These include:
essential fatty acids. Think of these as adding lubrication from the inside out. They also form part of the cell wall and hold water within the cells so this will support the skin to feel plumper and more elastic. Include oily fish 2 to 3 times a week, add flax seeds to your breakfast and keep nuts handy
vitamin C and collagen. The body cleverly uses vitamin C in the production of collagen and collagen is what gives your skin structure and plumpness.Don’t reach for expensive collagen supplements increase you fruit and veg intake and boost your vitamin C levels. Think about including red peppers, kale, cabbage, cauliflower as well as kiwi fruits and oranges
keep hydrated. Water is essential to make sure that your skin keeps its elasticity. You will get some water from the vegetables and fruits that you eat but it is important to make sure that you have enough. The amount of water varies from woman to woman but about 6 to 8 glasses a day is usually about right.
reducing sugar. Refined sugar is not good for the skin as it attacks and breaks down collagen.
You might have heard of Phytoestrogen’s. These are foods that mimic oestrogen in the body. If these foods are eaten in large quantities or if you have problems detoxifying oestrogen they can further disrupt your hormones causing other problems. This is because Phytoestrogens have been shown to have both estrogenic and antiestrogenic effects. This means that, while some phytoestrogens have oestrogen-like effects and increase oestrogen levels in your body, others block its effects and decrease oestrogen levels. I personally always air of the side of caution and will only recommend these foods to you if I have a full health history and an understanding of how you detoxify oestrogen to make sure that I don’t overburden your system causing more problems.
There is increasing research into targeted probiotics to support the vaginal microbiome and vaginal health. There is now private testing available that will help you identify if there are any bacterial imbalances and then have the appropriate probiotic support can be used to bring things back into balance and improve the moisture levels in your vagina. This type of testing is also perfect if you are prone to infections , both vaginal and UTIs, and are at a loss to understand why.
There are a number of supplements that can support BUT before you take any please seek advice as some may interact with medications. Vitamin E, Vitamin C, Vitamin D, fish oils, DHEA all have some evidence supporting them. Also, sea buckthorn oil has been shown to support the skin membrane and structure as well as reducing any inflammation. There is lots of anecdotal evidence about this oil BUT it can interact with certain medications especially blood thinners so please check before use as it can thin your blood further.
Other things to try
There are a number of over the counter products you can try to treat vaginal dryness yourself.
These include:
products you can apply topically e.g. vaginal moisturisers and water-based lubricants
targeted supplements
specialist foods
exercise
alternative therapies
Vaginal moisturizers. These add moisture to and around the vagina. They can be inserted for internal moisture or applied to the vulva to add moisture there.
Lubricants. These help reduce discomfort during sex and can be used in addition to a vaginal moisturizer. E.g. Yes, yes, yes, hyalofemme, or an natural lubricant oil
All soaps/washes should be avoided. Even the unperfumed soaps and washes - although they might be targeting vaginal dryness they can cause a disruption in the natural biome and really should be avoided.
Herbs such as Shatavari and targeted supplements. These would need to be checked against any medications you are taking or health conditions you have to ensure they are safe for you to take. If taking herbs please seek advice from a registered practitioner.
Essential oils can be very beneficial including clary sage, ylang ylang vetiver and lavender. Also diffusing geranium pink pepper and ylang ylang not only smells amazing BUT will also support your libido. If you are thinking about using essential oils please seek advice from a qualified practitioner. Some essential oils are unsafe to use with certain medications or health conditions.
Yoga. There are a number of yoga moves that will help to strengthen the and improve blood flow to the pelvic area. Yoga can also reduce stress hormones and reduce anxiety which will help with blood flow to the area and improve libido.
Massage/self massage. Helps with deep relaxation, connection to your body, reducing stress hormones and improved blood flow to the area.
Sex and vaginal dryness
Sex can become uncomfortable, painful and there can be increased chances of microtearing to the vagina wall.
Things you can do to help reduce pain during sex and add lubrication to the vaginal area include:
Vaginal moisturizers. (see above)
Lubricants. (see above)
Vaginal dilators. These can help stretch and enlarge the vagina if tightening occurs. These should be used under the guidance of a gynecologist.
Pelvic floor exercises. These help to strengthen and relax certain vaginal muscles allowing more comfortable penetration. Advice can be given from a gynecologist, physiotherapist or a sex therapist.
Vibrators. These help with blood flow to the area.
Staying sexually active enhances blood circulation in the vagina and stimulates natural moisture. Sexual activity has no effect on oestrogen levels. BUT it will improve blood circulation to the area and will help to keep your sexual organs healthier for longer.
Allowing more time to become sexually aroused can make sexual intercourse more comfortable.
Do you feel like you have tried everything and not getting the results you want?
It isn’t always talked about but psychological and emotional factors can also lead to vaginal dryness.
Stress and anxiety can interfere with your sexual desire. Plus the hormones linked to stress and anxiety affect the flow of blood to the vagina. If there is insufficient blood flow to the vagina it can directly lead to vaginal dryness for some women.
Low self esteem and lack of body confidence releases stress hormones in the same way as stress and anxiety does. Flooding your body with hormones that reduce blood flow to the area, reducing moisture and switching off arousal.
Lack of desire for your partner. If you and your partner have unresolved issues then it will be difficult to feel the desire to be intermate. Unresolved issues will cause increases in your stress hormones and this will have an impact on the blood flow to the tissues in the vagina and the amount of lubrication your body will make.
Unresolved trauma. Often unresolved trauma can come to the surface at menopause. There is some research linking childhood trauma/abuse with severe hot flushes and night sweats. PTSD can come to the surface years after the event has happened. If this is you then speak to your GP or health practitioner to discuss available therapies in your area.
Fed up of vaginal dryness during menopause?
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Lesley xx