Menopause Mondays: Do You Know About Vaginal Dryness? - Ellen Dolgen
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Menopause Mondays: Do You Know About Vaginal Dryness?

Got a Vagina?  Know someone who does?

Is your vagina going through troublesome changes? If it was, would you be aware of it? Would you speak about it to anyone?  Would you talk to your partner, lover, husband, or even your doctor about it?

Let me introduce you to Vaginal Atrophy (VA)!  Is Vaginal Atrophy in your vocab?  I think not!  Although, almost 1 in 2 post-menopausal women suffer from Vaginal Atrophy, we would rather speak of flatulence, bad breath, incontinence and hemorrhoids than utter these two words. Vaginal Atrophy gets 250,000 Google hits compared to ED (Erectile Dysfunction) which has 34,000,000!

Vaginal Atrophy is a silent symptom of menopause that is defined as the thinning and inflammation of the vaginal wall that generally impacts women in their menopausal journey.  VA occurs when there is a reduction in levels of estrogens which are produced by the ovaries.  Estrogens are responsible for maintaining the structure and function of the vaginal wall, elasticity of the tissues around the vagina, and production of vaginal fluid. Just between us, until I began my own perimenopause and menopausal journey, the only lining I had ever concerned myself with was located inside my blazer! I now understand the difference between a thick, healthy, well estrogenized vaginal lining vs. a thin, dry lining due to menopause – after estrogen loss. These vaginal and cellular changes are not pretty ladies!  When it comes to the vagina – thin is out!  VA can cause physical AND emotional challenges.

More than likely, since most of our mothers never sat us down and had a conversation about what to expect when you are expecting menopause, chances are she never uttered the words Vaginal Atrophy either. It is time to break the taboo and bust open up the conversation about the lining of our vaginas, because Vaginal Atrophy impacts all areas of a woman’s life and affects the people who love us, tool!!  Most women don’t even know what VA  is, nor  understand that it is a chronic problem that requires ongoing treatment and IS treatable. Therefore, this is information that we must learn about and share with the sisterhood.

I want you to be VA experts so that you can be proactive about your health and NOT reactive. So let’s get down to it:

What are the symptoms of VA?

  • vaginal dryness,
  • pain or bleeding in connection with sex (dyspareunia)
  • itching
  • soreness or irritation
  • painful or burning urination
  • incontinence (involuntary urination)
  • pain when touching the vagina

If you are experiencing any of the symptoms above, it could impact many facets or your life such as:

  • sexual intimacy
  • having a loving relationship with a partner
  • overall quality of life
  • feeling healthy
  • feeling attractive
  • feeling fit
  • exercising
  • traveling
  • participating in outdoor activities

If this is the case, why are women suffering in silence?

  • don’t realize that VA is a common consequence of low estrogen levels
  • do not think there is help for sexual and vaginal health issues
  • are unaware of the treatment options
  • find short term solutions for relief instead of treating the underlying problem
  • believe that menopausal symptoms end when the hot flashes stop

It makes total sense that VA is going to affect your relationships, health, and over all feeling of wellbeing!  According to the data from the Closer Study, 35 percent of women reported they do not feel sexually attractive anymore and 31 percent had lost confidence in themselves as a sexual partner.  Women who experience VA often feel isolated and alone which resulted in 24 percent reporting that they felt emotionally distant from their partners.

Let’s face it ladies, if you found that suddenly sex hurts and you would rather scrub your kitchen floor than slip into bed with your lover  – this would cause havoc with your relationships.  The men in our lives are affected, too. The survey showed that 65 percent of men worried that sex would be painful for their partners, and almost a third of both men and women reported that they have stopped having sex with their partners altogether because of the discomfort.

So what’s a gal to do???

1.   Be sure you have a specialist that is going to be your partner in this menopause business.  You can think of your doctor or nurse practitioner as your business partner or your own personal chef who is going to create an individualized menu just for you!  If you don’t have a specialist check out my Menopause Specialist Directory.  The doctors listed here have been recommended by the sisterhood.

2.    Ask for:

A pelvic exam to examine the pelvic organs; look at the vagina and the cervix.
A Pap test to take a sample of cells from the cervix. Get your vaginal secretions and  the acid level in your vagina checked.
A urine sample might need to be included, if you are experiencing unusual urgency or a leaky bladder.

3.    Talk with your specialist about the various options –systemic hormone therapy, creams, vaginal ring, vaginal tablets etc.  Listen to the facts and then together evaluate what is best for your individual needs.  One of the options available is local estrogen therapy (LET).  I know that many women have completely closed off their minds to anything related to hormone therapy.   It is interesting to note that this CLOSER global research did find that compared with other countries surveyed, 77% of US women were most likely to use lubricating gels and creams, and are the least likely to use hormone therapy, despite the advantages shown in the survey among those who sought treatment.  Of U.S. women who had tried local estrogen therapy (LET), 56% of women and 57% of their partners reported that sex was less painful, and almost 40% reported that sex was more satisfying for themselves and their partners.  Since the use of LET, 34% of women and 54% of men look forward to having sex after using local estrogen therapy.

The 2016 Revised Global Consensus Statement on Menopausal Hormone Therapy (MHT) which was published in Climacteric June 2016 reports that low-dose vaginal estrogen therapy is recommended for symptomatic women whose symptoms are limited to vaginal dryness or associated discomfort with intercourse. The use of systemic hormone therapy (see below) is not generally recommended in breast cancer survivors, although low-dose vaginal estrogen can be considered with consultation with oncology.

In addition, a new drug was approved by the FDA for painful sex — called Intrarosa.  It’s active ingredient is DHEA. This is, also, vaginally administered.

Another option is Osphenia which is a SERM Selective Estrogen Receptor Modulator.

This leads me to be 100% positive that we should be talking about Vaginal Atrophy!

4.  Communicate with your partner. When communication shuts down completely, everyone suffers, so it is important to keep talking. Don’t be embarrassed – be open and honest. This will strengthen your relationships not hinder them.

Help me break the taboo and open up the conversation about Vaginal Atrophy.  It is up to us to speak out and make sure that women are educated, empowered, and determined to get the help they need and deserve.

Remember:   Suffering in silence is OUT! Reaching out is IN!

Have you been checked for Vaginal Atrophy?



22 thoughts on “Menopause Mondays: Do You Know About Vaginal Dryness?”

  1. Thank you for all of the information you share with your readers.
    Please help me. I had a DVT and PE in 2004. It’s cause was not determined. The best explanation was use of birth control pills in the past. I was tested for genetic possibilities but nothing came back positive.
    In 2011 I has a complete surgical hysterectomy. I have been to a specialist I found on your site.
    No one can help me. I cannot take HRT and everything I’ve tried is useless. Do you have any words of wisdom?
    This topic especially hits home. After the hysterectomy I have had daily hot flashes, zero libedo, And VA.
    I’ve gained 50 pounds around my stomach and can’t do anything to lose weight.
    Can you please share any helpful information. Life is miserable right now. I see no information on someone in my situation.
    Thank you!!
    Joyce Hall

    1. So glad you reached out for support, Joyce. Wow…a deep vain thrombosis and a pulmonary embolism in one year! Yikes….sending you a virtual hug asap.
      There are other options for you. You do not need to suffer. Let’s take one at at time.
      1. hot flashes – Many doctors recommend Remifemin (estrogen-free black cohosh).
      2. VA – Talk to your doctor about LET (local estrogen therapy). LET is estrogen applied directly to vaginal tissues, so it goes directly to the affected area, with minimal absorption of estrogen into the bloodstream. LET is available in creams, a ring and a tablet. Also, read Menopause Mondays: Time for a Lube Job
      There is a list of lubes/moisturizers that women have found helpful. Give them a whirl!
      3. Weight Gain – I think you will find some helpful tips in this Menopause Mondays: Fight Menopausal Weight Gain
      Please LMK if you have any other questions…I am here for you. You are not alone!
      Good Luck and keep me posted.

    1. So true, Carol. Just yesterday, I received an email from a gal that has been unable to share a passionate evening with her husband because sex is so painful. She had no idea that this was a common symptoms of menopause and that it is treatable!

    1. I know, Doreen! So many women are suffering in silence. Please help me spread the word, so women know that they can get help for this.

  2. Helene Cohen Bludman

    You are such an incredible resource for women going through menopause. Thank you for always providing the most updated information!

  3. This is something that I definitely needed to read! I have been hit like a mack truck in the last two months with menopause or perimenopause I don’t even know. I only know that I need to do something about it now before it gets even worse. Thanks for this directory as well as the information that you have provided it is a huge help!

    1. I am here for you Rena. LMK if you have any other questions. In the meantime, be sure to download my Menopause Symptoms Chart and start charting your symptoms. This will help your menopause specialist understand exactly how you are feeling – quickly and accurately. If you don’t have a menopause specialist read this Dear Ellen for some tips on how to find one!

  4. The thing is there is just so much that can be done to help with this problem instead of suffering. I am lucky to have had a person in my life who basically demanded I do something about it…my beloved mother.

    1. Wow, Shelley! It is wonderful that your mother is so open about these things. You are very very lucky my dear!

  5. Yes, I just learned about this recently. I was educated by my gyno. You really are doing women a service by discussing this because we women tend to keep this very quiet. But when symptoms hit hard and out of the blue and your body is in pain, it is time to seek solutions.

    1. You are so right, Lisa! Sound like YOU have a great Gyn! Unfortunately, not everyone does. Share the info with your friends to that they are not embarrassed to reach out for help. Vaginal dryness is a treatable condition!

  6. I’ll never forget the day the male gynecologist looked up from between my legs and said, “yep, there’s a lot of atrophy down here.” Not the best day. It scares me that only 56% of women using LET said sex is less painful. That doesn’t sound like a great number. But thank you so much for tackling this topic! It’s so important.


    1. Amita, kuddos to your Gyn! Yes, so many women have this issue, but they are embarassed to talk about it to their partners or their healthcare professional. Help me break the taboo! Spread the info!

  7. I always love reading your great resources on these matters. This is a topic I’ve been curious about from hearing it in tv ads, since this part of menopause has not hit me yet. I can’t imagine.

    1. Wendy, not everyone experiences it. However, the important thing to remember is that IF you do – there are treatments to take care of it! Do not suffer in silence.

    1. Beryl, if you are still having pain then your prescription needs tweaking. Also, there are other methods of delivering local estrogen therapy – like a cream. You may find better results. GO back to your healthcare professional!!! There is no need to suffer!

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