Love your Vulva this Valentines Day! - Ellen Dolgen
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Love your Vulva this Valentines Day!

Happy Valentines Month – time to love your vulva!

First and foremost, if you haven’t been getting your yearly “V” physicals, book an appointment today and get into those stirrups for a check-up! If you don’t have a menopause specialist, click on this link for help.

Here is a little 101 primer to help you take control of your vaginal health, ask questions, and get a vaginal protocol to meet your health needs:

Labels You May Hear About

Most women first become aware of vaginal changes when suddenly, sex is painful. There’s actually a medical term for painful intercourse: dyspareunia (really??) If you’re experiencing pain during sex, you could be suffering from vaginal atrophy or VA (I used to think VA stood for Virginia, which ironically is for lovers.). VA is also known as vulvovaginal atrophy or VVA. The latest appellation, courtesy of the North American Menopause Society (NAMS), is genitourinary syndrome of menopause (GSM), a blanket term to describe menopausal symptoms that occur to the vulva, vagina, and lower urinary tract as a result of estrogen deficiency. Who makes up these words? Once again, the vagina gets the short end of the stick! I can’t even pronounce “genitourinary”! Perhaps the medical community should call in the Opi Nail Color Labeling Committee and come up with some better labels.

Anyway, vaginal atrophy is just that: a thinning of the vaginal wall thanks to a drop in levels of estrogen, whose job it is to maintain the structure and function of the vaginal wall, the elasticity of the tissues around the vagina, and the production of vaginal fluid.

We seem to hear more about hot flashes, insomnia, and memory loss, but vaginal discomfort is every bit as difficult—and critical—to deal with as other menopausal symptoms. Vaginal symptoms can negatively impact not only your relationships and sexuality but your quality of life and self-image.

In my experience, most women don’t understand that this is a chronic problem that requires ongoing treatment and IS treatable.

Understand the Symptoms

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

If you are experiencing some of the symptoms above, you are not alone. Vaginal dryness affects as many as 75 percent of postmenopausal women. Between 17 and 45 percent of postmenopausal women say they find sex painful, according to The North American Menopause Society (NAMS). According to the Women’s Health Concern, only 25 percent of these women seek treatment. What may be even more disconcerting is that, according to the International Menopause Society, 70 percent of women say their healthcare providers rarely or never raise the subject with them.

The Closer survey found that vaginal discomfort caused 58 percent of the women surveyed to avoid intimacy and 64 percent to experience a loss of libido.

The NAMS notes that pain during sex (or simply the fear of pain during sex) can trigger performance anxiety or arousal problems in some women. This also can diminish lubrication or cause involuntary—and painful—tightening of the vaginal muscles, called vaginismus. (Another one of these ridiculous words! Where is Merriam-Webster when we need her?) It’s a vicious vaginal cycle.

Possible Solutions 

  • Personal Moisturizer or Lubricant

Vaginal moisturizers, like facial moisturizers, can help relieve dryness and rebalance the acidity of the vagina. However, your vagina may need more. Non-hormonal vaginal lubricants can help decrease friction and discomfort during intercourse. Be sure that they are water-based and designed for vaginal use. Petroleum-based lubricants can harbor bacteria in the vagina and lead to infection, as well as damage latex condoms. As natural oils, some people use Organic 100% Sweet Almond Oil (this contains oleic and linoleic essential fatty acids, which helps your muscles relax) or Organic 100% Virgin Coconut Oil (this can help prevent yeast and bladder infections) as a lubricant. Both lubricants and moisturizers provide temporary relief of symptoms but often do not treat the underlying condition of vaginal atrophy.

Test all the lubricants on your skin first for potential irritation. Try the inside of your elbow or another spot where the skin is delicate.

  • Hormone Therapy

If you are all lubed up and still have no relief time to talk about hormone therapy.  There are two main types:

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 (def not jeweled), and a tablet.

In addition, there is a vaginal tablet approved by the FDA whose active ingredient is DHEA.

Systemic Hormone Therapy allows estrogen to circulate throughout the bloodstream to all parts of the body. It’s available in many forms: a pill, injection, patch, gel, and spray. Systemic HT is most often prescribed for multiple whole-body symptoms of menopause, including night sweats, hot flashes, and others.

Some women need a combination of LET and Systemic Hormone Therapy treatments.

  • Pelvic Floor Therapy

Our pelvic floors help open and close the sphincter and aid in sexual performance by stabilizing the clitoris. Your Gynecologist can evaluate whether you need pelvic floor therapy. According to Harvard Medical School, this is a safe and effective technique. A physical therapist uses massage and gentle pressure to relax and stretch tightened tissues in the pelvic area. You also learn exercises to help strengthen your pelvic floor muscles, which may have been weakened by aging, childbirth, or hormonal changes. Now that’s a massage with a happy ending!

This Valentines Day, love your vaginal self!

My Motto:  Suffering in silence is OUT! Reaching out is IN! 

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*EllenDolgen.com does not recommend, endorse, or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.

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