Vaginal dryness – The last menopause taboo

Jane Lewis has written this article to share her experience and help to empower women and break this taboo.  I am so grateful to her for allowing me to share this on my website.

Vaginal dryness / vaginal atrophy

Vaginal atrophy – it really is the very very last taboo of menopause. It is so hush hush that ladies are not even discussing it with their own partners / family / friends and even their GPs. So, I guess we really are not helping ourselves…

Perimenopause

Right, so let’s start at perimenopause, which for me was from about 46. Contrary to popular belief (amongst a lot of the medical professionals also) I was still having a regular cycle with no hot flushes. For me, both these seemed to get an answer of “well you can’t be in peri/menopause as you still have periods and no hot flushes” … which was definitely not the case for myself and many other ladies out there. We are not all text book cases, but are all individuals, which must be remembered by us ladies and the medical profession.

From the age of 35 our hormones start to fall at a dramatic rate as does oestrogen (which our urogenital area really needs). Perimenopause can for some last up to 12 years, all this time our bodies are on a roller coaster ride and the consequences of what can happen to the vaginal / bladder pelvic floor area is very much underestimated.

My experience

So at age 46, sex started to get painful and I would be sore afterwards for a few days… I realised a couple of years prior to this that my normal sticky clear discharge had completely gone with no discharge at all. Then at 46 I had a very watery milk like discharge (which I now know is one of the many signs of vaginal atrophy) and had a look (need to look ladies) – I was shocked, everything looked so dry / red raw/ thinning skin on the point of splitting, my urethra was so sore, labia atrophying it was like tissue paper, pubic hairs sparse. My bladder was also rather troublesome. By this point I could not wear pants / trousers / no sex at all/ sitting down was barely possible, going for a wee required using water to wash afterwards from the soreness – I felt like I was basically sitting on a bonfire a lot of the time. I also had stabbing pains in my vagina and the clitoris area, basically the whole area made me go almost mad, anxious and depressed.

We do not need to suffer

Some ladies get all of the above, others get one or two of them… there is no need to put up and shut up like previous generations (I have deepest sympathy for those ladies). However, as we are now living up to 30 years post menopause if you ignore these symptoms you/we are going to suffer unnecessarily as vaginal atrophy can’t be cured, it can only managed requiring continuous treatment for life. So this is not a stop/start scenario of treatment contrary to popular belief… perhaps another case of not knowing the real facts that surrounds this painful reality.

So that this phase in our lives we have gone from a lush green “English Country Garden” to the “Sahara desert” where the area now needs continuous hydration, otherwise it reverts to the Sahara dessert very quickly… similarly, do you stop watering your house plants?

Different treatments

I am now 50, and after 4 years of lots of trial and error I consider my vaginal atrophy managed, requiring rather a lot of time devoted to it… so what do I use / tried/ do now? I have tried almost every vaginal product available, all the local oestrogen creams / pessaries / ring / and systemic HRT. We have to be very careful with some of the products available as many of them have a high “osmosity” which puts our PH levels out of balance which can cause further problems and make the condition worse. Something like YES / sylk products are the best for us.

I am also using Oestrogel, which is the systemic oestrogen part of HRT, Utorgestan for the progesterone part (though considering having the Mirena coil fitted) plus the Estring (which is local oestrogen in the form of a silicone ring that sits high in the vagina for 90 days and releases a small amount of oestrogen continually). I also use Estriol cream on the vestibule area, and YES oil based to moisturise the area daily. So, as you can see I need everything for my urogenital atrophy, all these have helped.

Also, I have just completed my third “Mona Lisa Touch” treatment which so far seems to have made a positive difference. The skin looks amazingly healthy now and episiotomy scars that were almost splitting have bounced back. The treatment is all to do with promoting of collagen production. For ladies who have had breast cancer and may not be able to use oestrogen this is really worth investigating.

The Mona Lisa Touch is a laser treatment that is done both internally and externally with an average of 3-5 treatments required for the first round, and thereafter once every year to eighteen months. Internally it was painless for me, however externally it was painful but only lasts three minutes and after three days all was fine. What it has made me realise is that oestrogen is just not enough for us all, as before the treatment I could not use estriol cream and now I can without it burning. Some ladies don’t need to use local oestrogen anymore after the treatment, for others like myself it allows the oestrogen to work more efficiently. I will need the five treatments I feel, although unfortunately it is very expensive. I really hope that one day it will be on the NHS as this problem is not to be ignored anymore.

More education often needed

So, get yourselves educated and read the NICE guidelines. If necessary I am afraid you may have to go privately to sort this out, and get the care time you deserve.   Menopause seems to have been forgotten in any medical teachings, unless a professional has a real interest in learning about it… After all, 52% of the population are going to go through the menopause, we have bought the next generation into the world and it’s now our time to look after ourselves.

HRT is not all bad!

Don’t be scared of HRT; there is so much misinformation out there! The lack of hormones can and does for many have devastating consequences and this is no longer necessary. Also, the type of HRT I use is not exclusive to the rich and famous – it is all available on the NHS. Do not suffer in silence anymore. Educate yourselves and if necessary be prepared to educate your GP.

This is an independent review and the opinion of Jane Lewis. I have previously been reimbursed to provide advice on general menopause issues with regards to MonaLisa Touch (takeoutthepause.co.uk).