When you buy your ticket on the hormonal roller coaster, affectionately known as menopause, I have some bad news: Sorry, you probably won’t be making a stop at splash mountain. Nope, menopause brings lots of unexpected twists and turns and one big secret, your Va Jay Jay will be a lot dryer.
Ok, using correct terminology, the vagina gets a lot drier and less able to expand and stretch and, well, have fun.
Can You Say Sahara?
Yes, there will be more wrinkles, but you knew that. What many of my patients are surprised by is how dry their skin is, especially in their vaginas. The once healthy, pink, soft and flexible, stretchy accordion-like folds begin to thin out and are less flexible. And, what’s worse, now that you don’t have to worry about pregnancy, all of a sudden, your ability to lubricate recedes like a middle-aged man’s hairline.
Infections are More Common
Sorry to say, that when the vagina is dry, it means that the pH will also be off balance allowing less of the good health bacteria (lactobacillus) to grow and more of the bad bacteria that cause vaginal and bladder infections to flourish. This means that the pH which is normally slightly acidic will be slightly alkaline.These conditions are a set up for more vaginal and yes, even bladder infections, as opportunistic bacteria in the vagina travel toward the urethra and bladder. It’s not fun!
What to Do?
- Do not wait! Do not make the mistake of thinking that this will get better on it’s own. It doesn’t. It just gets worse.
- Don’t walk, run to your health care provider to discuss treatment options
There’s good news. Even if you’re not interested in hormones to treat hot flashes and night sweats, the good news is that a minimal amount of vaginal estrogen used regularly does not increase your risk of breast cancer, blood clots, stroke or any of the other serious side effects that are associated with hormone treatments for hot flashes and night sweats. It’s because the dose is much, much lower.
- Vagifem – Used every night for 2 weeks, then these small vaginal tablets are inserted 2 times/week
- Estrace & Premarin Cream – Directions can be customized. Typically it’s recommended that women use an applicator to insert 1-2 grams into the vagina every other night for 2 weeks, then to use 1-2 grams in the vagina 2 times/week. These creams can also be rubbed into the delicate labial tissue on the outside of the vagina.
- Estring – A flexible ring of estrogen that is inserted into the vagina. This slowly releases a small amount of estrogen over the next 90 days. Women don’t feel it inside and can easily use a finger to remove it and reinsert every 3 months.
Non Hormonal Options to Re-moisturize
There are a few vaginal re-moisturizers that I highly recommend to my patients:
- Replens – This is used every 2-3 days to help restore vaginal moisture. There are no hormones in this and it is a nice option for women who can’t use any hormonal treatment.
- Luvena – This is 100% natural and uses no alcohol, plus, it’s very slippery. It can also be used as a personal lubricant.
- Omega-3 Fish Oil – Everything gets drier in menopause from your eyes to your private girl parts. Consider taking 1-2 Fish Oil capsules each day.
You’re not alone if you need a lubricant. 50% of women of all ages do too!
- Astroglide – developed by NASA, but not for sex in space.
- Luvena – is edible. Could be fun!
- Carrageenan – has aloe and agave and is very effective.
- Olive oil, coconut oil, wheat germ oil – anything that you can use in cooking, you can use in the bedroom.
- Slippery stuff – always gets high ratings.
You can find many more helpful products through MiddlesexMD, a great resource for women at midlife.
What’s Your Advice?
I want to hear from you about what works.
For more tips, please check out my new book, The Hot Guide to a Cool Sexy Menopause. It’s available on Amazon, Barnes and Noble, for E-readers, wherever books are sold and through Basic Health Publishing.
Disclosures: I have no financial ties with any of the products listed above. I am on the speakers bureau for Vagifem.