Take a seat, because we need to have a conversation about vaginal dryness. Personally, I find it one of the most troublesome symptoms of menopause. Intimacy is no longer effortless, and that has an impact on me. Did you know that one in three women experiences this?
Let’s begin with a quick biology lesson. Vaginal dryness is a broad concept. You might experience pain on the outside (referring to the labia minora, labia majora, and clitoris) or pain or dryness on the inside (the cavity where you would insert a tampon: the vagina).
You might only feel discomfort during intimacy, or you could also experience a burning, raw sensation while cycling or wearing tight clothing. Additionally, you might deal with an infection or a tightening of the vagina; these are all distinct issues.
It’s important to first identify the specific problem. If you’re unable to determine the cause with your GP, it’s best to ask for a referral to a gynaecologist.
Research also shows that many women don’t visit their doctor about this issue and are hesitant to discuss it. Such a shame, because there’s so much that can be done—if you’re open to it.
I want to focus here on atrophy, as it’s the most common cause. Atrophy refers to vaginal dryness caused by a decrease in oestrogen production, which makes the vaginal tissue and epithelial layer (found in the mucous membranes) thinner, drier, and less elastic.
This leads to symptoms such as a painful, dry vagina, a raw sensation during intimacy, redness of the labia, and increased susceptibility of the tissue to infections.
Many women think they’re dealing with vaginal atrophy because they experience pain during intimacy due to a dry vagina. However, nearly 80 per cent of them actually mean that they’re not becoming lubricated during intimacy. That’s something entirely different.
While the vagina does naturally become drier around menopause, it can still become just as lubricated as before when aroused. It might just take a little longer. You need to be aroused first, and often we don’t take the time for that.
Atrophy is unrelated to intimacy or arousal. The vaginal wall becomes thin, red, or uniformly pale on the inside, and friction can cause tears (even from movements other than intimacy). This causes pain, which, of course, doesn’t help with arousal. However, atrophy can be effectively treated with a cream.
Using a cream can make the vaginal wall more elastic and thicker, so intimacy doesn’t have to be painful. Well-known options include creams or suppositories containing estriol. Estriol is a mild form of oestrogen that also improves blood circulation.
Women with atrophy don’t have to experience pain and are perfectly capable of becoming lubricated, provided there’s enough desire and arousal.
These insights aren’t mine but come from gynaecologists I’ve interviewed. They’ve been incredibly helpful to me. There are creams, tablets, and suppositories that work well. Well-known options include Oestrogel (a gel) and Vagifem estradiol tablets. It may take a few weeks to notice results. A non-oestrogen option is Senshio.
Maybe you’re thinking: forget about sex, I’m done with it. That’s perfectly fine, of course. But if you do want to continue, talk to an expert. Don’t be afraid to discuss it, consider hormone therapy, explore different solutions, or try something new. Life can become so much more enjoyable. I speak from experience.
Wies Verbeek (58) is a journalist, founder of the website BLOW.nl, and author of the book ’n Beetje Leuk Ouder Worden, 101 verrassende en bewezen tips. She’s also in the midst of menopause.
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