The Overlooked Side of Menopause: Vaginal Health Matters
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There is so much about perimenopause and menopause that is complex. One area that is pretty straightforward and important, but not discussed enough, is vaginal tissue health: the changes that happen and treatment options.
Genitourinary symptoms during menopause are EXTREMELY common. Vaginal and urinary tissue has a high concentration of estrogen receptors and is very sensitive to symptoms as estrogen declines. The numbers suggest that 60-100% of women will have a sign or symptom of genitourinary syndrome, but only 14% of women discuss genitourinary symptoms with their healthcare providers!
Genitourinary syndrome of menopause (GSM) encompasses:
Vaginal dryness
Itching and burning sensation in the vagina and vulva
Discomfort and pain during intercourse or other sexual activity
Thinning and decreased elasticity of vaginal tissues
Decreased vaginal lubrication
Increased susceptibility to vaginal infections
Discomfort with urination
Increased risk of urinary tract infections
These symptoms typically worsen over time due to aging and prolonged lack of estrogen; and they tend to continue to become more severe if left untreated.
They can significantly impact quality of life and sexual satisfaction. We want to treat them!
Treatment typically involves one or a combination of three:
Vaginal moisturizers. Vaginal moisturizers typically contain hyaluronic acid as an active ingredient. They work to hydrate the tissue and support vaginal pH to reduce tissue irritation and damage and support tissue elasticity. They are intended to be applied regularly and can be used in conjunction with vaginal estrogen.
Vaginal estrogen. Vaginal estrogen is a very safe, targeted local therapy. It is different than menopause hormone therapy as it’s applied locally and does not seem to be absorbed systemically. Maintaining estrogen in the genitourinary area can support the vaginal flora (bacteria balance), pelvic sensation and tone, and health and function of the tissue. As such it can alleviate vaginal dryness and atrophy, reduce urinary tract symptoms, prevent UTIs, enhance sexual experiences by improving vaginal lubrication, and improve quality of life.
Lubrication. This is not a treatment for GSM but can help to decrease tissue damage. Lubrication is meant to be used during sexual activity to decrease tissue friction. It’s not treating the concerns but is helpful to prevent further issues and allow sexual activity to be more enjoyable.
If you’re having any vaginal/urinary concerns associated with perimenopause/menopause, it’s important to discuss these options with your healthcare provider! While vaginal moisturizers and lubricants can be purchased over the counter, there are some intricacies of ingredients and osmolarity that are helpful to discuss. Vaginal estrogen requires a prescription and is in my scope of care as a prescribing Naturopathic Doctor.
Disclaimer:
This content is for informational and educational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, naturopathic doctor, or other qualified healthcare provider with any questions you may have regarding a medical condition or health concern. Never disregard professional medical advice or delay seeking it because of something you have read here.
Hi, I’m Dr. Janine, ND
I’m a Naturopathic Doctor currently practicing in Guelph, Ontario, Canada.
I truly believe that our enjoyment of life is closely tied to how we feel physically. When we’re healthy, we can take on anything. But when we feel off, even the simplest tasks become overwhelming. I’ve been through hormonal shifts, sleepless nights as a parent, and the stress of balancing everything. But I also know that with the right strategy, we can go from surviving to thriving—and create a healthy, thriving family in the process.
I look forward to meeting you soon.
- Dr. Janine, ND
Follow me on social media, @dr.janine.nd