Of the many challenges that women face in the menopause and perimenopause years, there is one that seems to cause the most distress. Vaginal dryness.
A 2017 survey by the British Menopause Society, found that 50% of us are too embarrassed to speak to our doctor about vaginal dryness. And yet the same survey showed that 51% of women said sex is off the menu due to vaginal dryness, vaginal atrophy and vaginal tightness.
The symptoms can cause painful sex, decreased libido, decreased sexual sensation and body confidence. So we really do need to talk about this.
Vaginal dryness: the facts
Vaginal dryness can impact women, whatever their age, as a result of hormonal changes, anxiety, stress, cancer treatment, breastfeeding and side effects of some medications.
During perimenopause and menopause, the depleting oestrogen can lead to a thinning of the walls of the vagina and the skin of the vulva, making it shrink, feel sore, drier and less well lubricated. This can make sexual activity feel uncomfortable or painful and may lead to infections such as thrush, bacterial vaginosis and irritation.
The walls of the urethra that lead from the bladder also thin, leading to the risk of infections. This includes cystitis and urinary tract infections, as the walls of the urethra become irritated and inflamed during penetrative sex.
Some women experience vaginal atrophy, which is much more than vagina dryness. It can lead to splitting or tearing of the vulva/vagina, constant itching, burning, soreness, discomfort and recurrent urinary issues. This is why seeking medical advice to get the right diagnosis and treatment is important.
The vulva is the external part of the female genitalia protecting our sexual organs, urinary opening, vestibule (vagina entrance) and vagina. It consists of the outer and inner ‘lips’, called the labia majora and labia minora, the clitoral hood and clitoris and is key to the sexual response in the majority of women and those with a vulva.
The vagina is an elastic, muscular canal with a soft, flexible lining that provides lubrication and sensation connecting the uterus to our external genitalia.
READ MORE Does menopause affect your libido?
Every woman needs the right lubricant in her life
As the owner of a sex toy company, Jo Divine, I know that using a sexual lubricant enhances your sexual intimacy and pleasure. I always recommend that our customers use a pH balanced, skin safe sexual lubricant with all our sex toys, and for sex play too.
My own vagina health and sex life was destroyed by using poor sexual lubricants in my 20s and 30s. I spent many years suffering from thrush, bacterial vaginosis (BV), recurrent cystitis and urinary tract infections that led to vaginismus. I had no idea that many well known high street lubricant brands contained detrimental ingredients, including glycerin, glycols and parabens, and that these caused sexual health issues.
I also self treated many of my vaginal symptoms with widely available feminine hygiene products that actually exacerbated my symptoms, rather than alleviating them.
Not all sexual lubricants are the same
We know that sexual lubricants enhance sex, making it more pleasurable and even longer lasting. At Jo Divine we often advise people who have tried a lubricant or been recommended to use a product by their GP, which caused irritation. This has put them off trying another product because they think all lubricants are the same. Not so.
I am passionate about sex education and educating everyone about vagina/vulva health. Many customers tell us about the inappropriate and potentially detrimental products women are using as sexual lubricants. These include antiseptic creams, hand creams, baby oil, olive oil and coconut oil, all of which can cause thrush, bacterial vaginosis or irritation.
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Through the work I do with menopause experts and healthcare professionals, I have heard stories about people cleaning their vaginas with Dettol, Savlon, feminine washes and intimate wipes, all of which disrupt the delicate pH of the vagina and can lead to irritation and infection.
When choosing a vaginal lubricant, check the ingredients for glycerin, glycols and parabens as these can disrupt the delicate pH of the vagina flora leading to infection or irritation. If you know you are prone to thrush, it is important to avoid products, including those on prescription, which contain glycerin as it creates a sugary environment for thrush to flourish. Even if a product says it is pH balanced it may contain irritating ingredients.
Many water-based products are also hyperosmotic which means they draw moisture from the walls of the vagina, not hydrate it, so exacerbate vaginal dryness.
It is important to do a skin test before using any product to avoid any irritation, stinging or itching. Perfumed and flavoured products and those that have a warming effect (they contain capsaicin found in chillies) and those that cool (they contain menthol), can all cause irritation.
The lubricants that work for me
When I reached perimenopause in my early 40s, I discovered YES organic lubricants, which are water based and oil based, and made a huge difference to my vagina health and sex life. Now that I’m menopausal, I use YES vaginal moisturiser twice weekly and a topical oestrogen pessary (Vagifem) three times weekly. This keeps my vagina happy and healthy. I always pee before and after sex to flush out any bacteria, and I even use YES oil based lubricant to protect my vulva when I go swimming in the sea and pool.
Your vagina should not smell like roses
Vaginas/vulvas are self cleaning so why are there so many feminine hygiene products aimed at cleaning, scrubbing, detoxing, cleansing, hydrating, moisturise and making our genitals smell fresh and look younger? There’s even vulva makeup.
From intimate washes, to perfumed menstrual products and scented condoms, detoxing sticks and herbal bags, glitter makeup and lubes and fur oil for our pubic hair, our vaginas and vulvas are the last part of our bodies being targeted by wellness/beauty brands.
Got a perimenopause or menopause question?
The myth that our vaginas need cleaning is perpetuated by a feminine hygiene industry forecast to be worth £33.5 billion worldwide by 2022, according to analyst Allied Market Research. The same report found that ‘internal cleansers’ were the fastest-growing product category.
I’ll be clear, our genitalia only need to be washed with water.
While this fast growing industry continues to sell these products, women will continue to think they need them, especially when their favourite celebrity, beauty brand or TV doctor is touting them. While women continue to buy them, brands will continue to make huge amounts of money.
Stop self treating intimate health issues
Worryingly, many of these products can and do mask vagina/vulva health issues. This is especially true of those more prevalent in perimenopause and menopause which require medical treatment, such as recurrent thrush, bacterial vaginosis, vaginal atrophy, lichen sclerosus and even vulval cancer.
From my own experience, I know that it is too easy to grab a product from the chemist to treat that itch, sore vulva, vaginal discharge or smell which may temporarily ease your symptoms but ultimately will prolong or exacerbate them. It is frustrating when you hear healthcare professionals (HCP) recommending such products without examining women or taking a swab. Many women get advice from pharmacists without them having any real idea what their symptoms are or they self treat because they are too embarrassed to see their GP.
READ MORE Perimenopause, HRT and sex drive.
It is important to seek medical advice to get the right diagnosis. HCPs need to ask patients what they are washing their vulvas and vaginas with, what they are using as a sexual lubricant. The professionals should also educate themselves about the detrimental ingredients that many feminine hygiene products, sexual lubricants and vaginal moisturisers contain, which can and do impact upon intimate health.
Your vagina needs you
If you are one of the millions of women who struggle with their vagina health during perimenopause and menopause, do your research and find a pH balanced sexual lubricant or vaginal moisturiser that works for you and keeps your vagina healthy.
For me, discovering YES organic lubricants/moisturisers transformed and saved my sex life and vagina health. My advice to you? Become lube-savvy and just as you would pay attention to your diet and skin care products, choose your sexual lubricants/moisturiser carefully. YES will send you samples to try, something I highly recommend.
Discovering a pH balanced sexual lubricant/moisturiser that works for you will enhance both your sexual health and pleasure, whatever your age and keep your vagina/vulva healthy and happy.