Dry Spells: Breaking the Silence on Vaginal Dryness in Midlife Women

Let's talk about something that doesn't get nearly enough airtime at brunch tables or ladies lunches: vaginal dryness. Yes. It's a common issue that many women face, especially during midlife and after menopause. Yet, it's often left unspoken in favour of more "comfortable" topics. But why should it be? After all, discussing the latest binge-worthy series of Bridgeton or debating the merits of oat milk is all well and good. However we need to be able to talk about our vaginal health without shame or embarrassment.

Understanding Vaginal Dryness

Vaginal dryness occurs when the tissues of the vagina are not well-lubricated. This can lead to discomfort, itching, and pain during intercourse. The primary culprit? A drop in estrogen levels. Estrogen helps maintain the thickness and elasticity of the vaginal walls and keeps them moisturised. As women approach menopause, estrogen production decreases, leading to that unwelcome desert-like sensation.

But menopause isn't the only factor. Stress, certain medications (like antihistamines and antidepressants), childbirth, and even some hygiene products can contribute to vaginal dryness. It's a multifaceted issue that's more common than you might think.

While we're on the topic, vaginal dryness isn't the only concern. Many women also experience:

• Vaginal Atrophy: Thinning and inflammation of the vaginal walls due to decreased estrogen.

• Urinary Incontinence: The unintended leakage of urine, often triggered by weakened pelvic floor muscles.

• Infections: Changes in pH levels can make the vagina more susceptible to infections like bacterial vaginosis or yeast infections.

These issues can significantly impact a woman's quality of life, affecting everything from being afraid to cough or sneeze whilst out and about to being intimate with her partner.

You might be thinking, "Am I the only one dealing with this?" Absolutely not. According to the North American Menopause Society, up to 50% of postmenopausal women experience symptoms of vaginal dryness. That's half of us!

Yet, many women feel too embarrassed or resigned to seek help.

Dr. Kelly Casperson, a urologist making waves with her book “You Are Not Broken” and her series The Vagina Dialogues, emphasises that open conversation is key.

"So many women suffer in silence, thinking they're alone or that nothing can be done," she says. "But understanding your body and knowing that solutions exist can be incredibly empowering."

The good news? You don't have to grin and bear it. There are both hormonal and non-hormonal solutions to help you find relief.

Hormonal Solutions

• Hormone Replacement Therapy (HRT): Systemic estrogen therapy can alleviate vaginal dryness along with other menopausal symptoms like hot flashes.

• Topical Estrogen Treatments: Creams, tablets, or rings inserted into the vagina deliver estrogen directly to the tissues, minimising systemic absorption.

• Selective Estrogen Receptor Modulators (SERMs): Medications like ospemifene can mimic estrogen's effects on vaginal tissue without affecting other organs.

Non-Hormonal Solutions

• Vaginal Moisturisers and Lubricants: Over-the-counter products can provide immediate relief

• Lifestyle Changes: Staying hydrated, maintaining a balanced diet rich in omega-3 fatty acids, and avoiding irritants like scented soaps can make a difference.

• Pelvic Floor Exercises: Strengthening these muscles can improve blood flow and tissue health.

• Alternative Therapies: Some women find relief with treatments like laser therapy, though it's essential to consult a healthcare provider for efficacy and safety.

Dr. Casperson encourages women to explore these options without shame. "Your sexual health is a vital part of your overall well-being," she notes. "Don't let outdated taboos prevent you from seeking the help you deserve."

Conclusion

Vaginal dryness is a common, natural part of aging however you do not have to suffer in slince. By opening up the conversation and exploring available solutions, you can reclaim comfort and confidence. Talk to your gynaecologist, share your experiences with friends, and remember: you're not alone in this.

In order for our garden to flourish it needs to be fed and watered ;-)