Vaginal discomfort is a little talked about symptom of the menopause but there are treatments available.

Vaginal problems
Without the production of estrogen by the ovaries, the skin and support tissues of the vulva and vagina become thin and less elastic. This condition, known as atrophic vaginitis, is an inevitable consequence of the menopause and the majority of women will experience some form of symptoms. These symptoms can last for many years – about 7 out of 10 women in their 70s have symptoms related to atrophic vaginitis.

Vaginal dryness is often the first reported symptom. This is due to a reduction in the production of mucus by the glands of the vagina.

Painful sex (dyspareunia) is a common problem at this time. Thinning of the vaginal and vulval skin makes them more easily damaged. This damage can occur during sex, especially if lubrication is also poor. Even quite gentle friction can cause pain and discomfort. If the vulval lips are thin and dry, they may rub on underwear causing soreness.  For many women, sex becomes uncomfortable and painful around the time of the menopause which can cause relationship difficulties.

Alteration in the normal vaginal discharge is something noticed by most women after the menopause but rarely discussed. Without estrogen the pH (acidity) of the vaginal secretions changes and the normal discharge becomes more alkaline. This pH affects the balance of the micro-organisms in the natural secretions which in turn suppresses the normal levels of “good” bacteria (lactobacillus). The discharge changes in nature, becoming watery, discoloured and slightly smelly.  This often leads to vaginal burning and vulval irritation.

Urinary symptoms
As they get older, many women may find they have problems with their urinary tract.

Some suffer from genuine stress incontinence, which is leaking of urine on coughing, sneezing or jumping, for instance.  There is still a lot of debate about whether this is a direct result of the loss of estrogen after the menopause.  The mechanisms of genuine stress incontinence are complex and estrogen-loss is only a part of this process. About 70% of women with stress incontinence relate its onset to the final menstrual period.

Urge incontinence - some postmenopausal women have difficulty “holding on” once they sense that they need to empty their bladder. They may also leak and start to pass urine before they can get to the toilet.

Other associated symptoms of the overactive bladder include frequency (recurrent need to pass urine) and nocturia (need to pass urine at night leading to recurrent wakening). Some women also feel they need to pass urine, having only just done so. All these may be connected to over activity of the muscle surrounding the bladder.

Women of all ages can be affected by recurrent urinary tract infections (UTIs), but these infections are more common in postmenopausal women. Elderly women are often particularly troubled by recurrent UTIs.

Many women decide to “pad-up and put up” and suffer in silence, rather than face the embarrassment of discussing these problems and finding out if anything can be done to help. Women are often unaware of:

• How common and normal these problems are
• What help is available to them

HRT products available specifically for vaginal dryness

For information on other types of HRT products, click here.

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