Vaginal Atrophy (VA), known in the medical profession as Genitourinary Syndrome of Menopause (GSM) is a slient epidemic affecting many women across the UK and the world, yet it is little talked about as they suffer in silence and leaving many women suffering long term in pain, discomfort, giving up on their sexual reationships and unable to undergo pelvic examinations for cervical screening and other gynaecological investigations.
This isn’t just affecting women experiencing a natural menopause but many younger women going through the menopause as a result of cancer treatments or conditions such as Premature Ovarian Insufficiency (POI) and those who are perimenopausal also experience Vaginal Atrophy symptoms too.
Reported prevalance rates of Vaginal Atrophy or Genitourinary Syndrome of Menopause vary but it is estimated that around 15% of premenopausal and around 57% of post menopausal women experience this condition. However many healthcare professionals believe the figure could be much higher as many women do not seek advice due to embarrassment, believing it is a normal part of the menopause they have to live with or think there is no treatment.
Jane Lewis who set up the Vaginal Atrophy FaceBook group to help fellow sufferers has kindly written this amazing blog about her journey, living with Vaginal Atrophy and the ways in which she is slowly overcoming her symptoms and learning to manage them.
VAGINAL ATROPHY (renamed GSM Genitourinary Syndrome of Menopause) whatever you want to call it, if you have it, it can make your life miserable.
My name is Jane Lewis, I am 51 and have been suffering from vaginal atrophy for almost 5 years. It is the part of menopause that is just not discussed, either by women or by the medical profession. It seems to be a topic which almost has a shroud of embarrassment around it because it is related to our vaginas, vulvas and bladders, a subject that can get everyone fidgeting in their seats, gazing into thin air and avoiding eye contact.
So why have I, you may ask decided to write about it? Because I have three daughters and I do not want them and the next generation of women going blindly into the menopause, being as unprepared as I was and millions of other women worldwide were and still are.
Most women (myself included) thought that menopause was a few hot flushes, anxiety, possibly heavy periods, then it all stops and life carries on as normal. Sadly, what up to 80% yes, 80% of women don’t realise is that Vaginal Atrophy will affect a vast majority of us in one way or another, yet only about 7% of women discuss it with their GP.
Symptoms of Vaginal Atrophy
So if you suffer from:
- vaginal dryness
- experience painful sex
- bleeding after sex
- suffer from burning, irritation and itching in your vagina and around your vulval area
- have recurrent urinary tract infections (UTIs)
- can’t sit down comfortably
- can’t wear your favourite jeans,
- your vulva area, labia, clitoral hood are shrinking / disappearing
- your perineum is splitting from old episiotomy scars
then it is highly likely you have Vaginal Atrophy.
You may have one of these symptoms, a few or, if like me, all of them (so why, oh why aren’t we warned about it ?). Obviously all other vulvar/ gynae conditions need ruling out which is why seeking medical advice is so important.
Even though we’re menopausal we still need to continue to have cervical screening yet smear tests very often feel painful and sometimes can’t be done. Although many women report finding having a smear test uncomfortable for a few minutes, it can save their life so if a woman is unable to have her smear test because it is too painful or uncomfortable, this is when we should be referred to our GP and our options discussed.
Vaginal Atrophy Treatment Options
These options should include local oestrogen in the form of vagifem, estring, ovestin and estriol. Some ladies also require Hormone Replacement Therapy (HRT), I use local oestrogen (Estring) in addition to taking HRT as using the local oestrogen on its own was not enough and using a good quality sexual lubricant can help or if you don’t want to/can’t use oestrogen/ take HRT.
We have to be careful about what lubricants we use as some contain ingredients, such as glycerin which can cause thrush, glycols which are vaginal irritants, parabens which are oestrogenic so should never be recommended for women after cancer and some are not pH balanced to that of the vagina so cause vaginal infections such as bacterial vaginosis.
KY jelly contains all of the aforementioned ingredients and should never be recommended for Vaginal Atrophy or really for sexual use, yet many GPs still recommend or prescribe it! It also has a high osmolarity which causes it to draw moisture from the walls of the vagina, making your Vaginal Atrophy much worse.
I personally only use YES products. The water based YES lubricant is available on prescription so ask your GP to prescribe it. Be aware that some lubricants and vaginal moisturisers on prescription contain some of the less vagina friendly ingredients so ask your GP to check before they prescribe you something. You don’t want a product to make your Vaginal Atrophy worse!
I have also had a procedure called The Mona Lisa Touch (MLT) which is a laser treatment. On writing this I had just completed my 4th and need one more, and at this point I am very happy with the results ….
This is not a designer vagina as the press report it , but is a procedure that is helping many women lead a happier life, unfortunately MLT is only available privately.
Lastly, as we age our vaginas shrink, it’s where the saying “use it or lose it “ comes from , however for many ladies intercourse is no longer possible as they have either become too tight or it is simply too painful. However it is important to try and keep the area “ open” so to speak , to enable you to continue having smear tests until age 64 and any potential intravaginal scans or gynaecological investigations.
So I have been using the Picobong Zizo from Jo Divine.
Normally ladies are given dilators to keep the vaginal area open and some of these can be rather hard and unforgiving , but the Zizo is much softer and better shaped, I personally do not use it as a vibrator but as part of my women’s health physiotherapy , it can be used to gently stretch the vaginal opening and to keep the vagina supple, hopefully making smear tests and intercourse more comfortable if you want to.
However there is no pressure to have penetrative sex. If it really is not possible, do not feel pressured because as they say, there’s more than one way to skin a rabbit .
Jo Divine is a very helpful company and happy to answer any of your questions if they can , I believe that if the Zizo is too big there are smaller ones and soft silicone dilators available which may help, just email or ring and discuss your problem. Samantha has a nursing background so can offer practical advice about enjoying sexual intimacy and pleasure. All conversations remain confidential too.
The only way Vaginal Atrophy is going to be taken more seriously, is purely by US ladies talking about it , it really is just a “vagina” and 51 % of the population have one. It has to STOP being the very last taboo of menopause……as it really can ruin lives and in some cases, marriages.
I am a 51 year old mother of three daughters who, until 6 years ago, owned a horse and rode most days all year, enjoyed going to the cinema, meals out, all the normal things we take for granted but then menopause and vaginal atrophy made itself known.
I hope my story makes you feel less alone and gives you the courage to discuss it with family, friends and your GP. Unfortunately if you do nothing and try to ignore it, it’s the one part of menopause that doesn’t just go on it’s own, it’s an ongoing problem needing TLC.
Jane has written this fabulous book about her experience, full of practical tips, advice and ways to get the conversation started about vagina health. If you have a vgina, know someone with a vagina or are a healthcare professinal you need to read this book!
Me & My Menopsausal Vagina: www.mymenopausalvagina.co.uk
Jane has also created a useful leaflet you can download or request via her website or on twitter @mymenopausalvag or instagram my_menopausal_vagina
At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!
The health brochure is available free of charge to healthcare professionals in the UK to give to their patients and the general public. Please email or call to request a brochure.
Dr Louise Newson : www.menopausedoctor.co.uk – fantastic website offering all the advice you need to go through the menopause.
Menopause Support: www.menopausesupport.co.uk – brilliant support group offering all aspects of menopause support with Dr Louise Newson giving her expert advice too.
Henpicked : Menopause in the Workplace www.menopauseintheworkplace.co.uk – offering workplaces professional advice to help women manage their menopausal symptoms at work.
Vaginal Atrophy Facebook Group – fabulous support group set up by Jane for women experiencing VA, offering their personal experience and advice as to what does work, what may work and what to avoid.
Pelvic, Obstetric and Gynaecology Physiotherapy womens health physiotherapy – womens health physiotherapists are trained to help women overcome gynaecological issues of the pelvic floor and restore pelvic health. Many WH physios are based in NHS hospitals so ask to be referred by your GP.
Royal College of Obstetricians and Gynaecologists:
Vulva Pain Society: www.rcog.org.uk
British Menopause Society: www.thebms.org.uk