Female genitals are filled with oestrogen receptors. We have lots of oestrogen circulating around the body before the menopause and this acts on those receptors to keep the vaginal and vulval tissues healthy, plump, well lubricated and stretchy.
Oestrogen also maintains the vaginal environment at an acid pH which creates a barrier to infection.
When oestrogen levels fall at the menopause the tissues can become thin, irritated, often dry and fragile with splitting of the skin around the vagina and perineum being a common symptom. The natural architecture and anatomy of the vagina and vulva can change with loss of oestrogen, causing the vaginal entrance to become smaller and the clitoris either hidden or uncomfortably exposed.
There are many oestrogen receptors throughout the urinary system as well as the vagina. Consequently, the changes in the vagina around this time will almost certainly be happening alongside similar changes in the bladder and urethra. Thus urinary symptoms frequently accompany vaginal symptoms.
Common urinary symptoms are incontinence, frequency, recurrent urinary tract infections and bladder irritation.
We use the term ‘vaginal dryness’ a lot but not all women have a dry vagina at this time- in fact some women experience increased secretions with soreness and weeping which is often due to a change in vaginal flora from the loss of acidity in the vagina after the menopause.
All these symptoms can have a profoundly negative effect on intimacy, relationships and enjoyment of sex as well as overall quality of life. Even sleep can be affected- a sore itchy vagina and several trips to the loo are unlikely to result in a peaceful nights slumber
Take home messages
-be aware of your vaginal health- its important!
-fill your vagina with oestrogen
-the burning, itching and discharge probably isn’t thrush…
-ASK ASK ASK! If other body parts not covered by skin were suddenly exposed to the environment with no lubrication (eyes, inside your nose, mouth) you would want to see a doctor- if every speck of dust that got into your eye was causing burning and pain you would want to get it checked out. It’s the same for your vagina. Don’t be afraid to ask. We can help.
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