At menopause as hormone levels decline, women start noticing signs of dryness or tightness and sex may become uncomfortable

There are several reasons for this, and a number of conditions that can arise at this time may need to be investigated.

Dealing with dryness

This is most common at menopause and related to the declining oestrogen levels that occur at this time.

This is not serious physically, though can certainly be distressing, and there are a number of lubricants available.

If you have mild to moderate vaginitis, using a lubricant can help relieve pain and discomfort while having sex but they provide short-term symptom relief and can improve vaginal dryness during sex, but theres no evidence to show theyre an effective long-term treatment.

Several types of lubricant are available some are water-based and some aresilicone-based. You may need to try a few before finding one thats suitable or your GP may wish to prescribe a localoestrogen cream, gel or pessary.

If you prefer a natural alternative then 20-1, which is a combination cream with the majority ingredient of progesterone with two natural oestrogens added, can help particularly if internal vaginal application is used.

Vaginitis

This is inflammation of the vagina that can cause itching, discomfort and discharge. Itcan be caused by any of the following infections or irritants:

thrush a common yeast infection that affects most women at some point

bacterial vaginosis a bacterial infection where the balance of bacteria inside the vagina is disrupted

trichomoniasis an STI (Sexually Transmitted Infection) caused by a tiny parasite

chemical irritation for example, from perfumed soap, bubble bath, or fabric conditioner, or from spermicide and somesanitary products

washing inside your vagina

chlamydia an STI caused by bacteria

gonorrhoea an STI caused by bacteria

genital herpes an STI caused by the herpes simplex virus.and symptoms include:

Symptoms can include the following

an abnormal vaginal discharge

vaginal irritation or itching

pain when peeing or having sex

light bleeding or spotting

a strong, unpleasant smell, particularly after sex, can be a sign of bacterial vaginosisor trichomoniasis, which can sometimes cause vaginitis.

Time to see your GP orgo to a sexual health clinicif you have any unusual vaginal symptoms, particularly if you have :

vaginal itching or an unpleasant smelling vaginal discharge

havent had a vaginal infection before

had vaginal infections before but now your symptoms are different

had a number of sexual partners, or you have a new sexual partner so you may have a sexually transmitted infection (STI)

finished a course of medication for vaginal thrush, but your symptoms are persisting

Theres no need to see your GP if youve been diagnosed with thrush in the past and your symptoms arethe same.If youre sure you have thrush and youve treated it successfully in the past with over-the-counter medication, you can treat it yourself again.

Treating vaginitis

Treatment for vaginitis depends on whats causing it.Yeast infections, such as vaginal thrush, are usually treated with antifungal medicines, and bacterial infections are usually treated with antibiotics.

Vaginal atrophy

This refers to thethinning of the lining of the vagina after the menopause and the resultingdryness, itching or discomfort (particularly during sex). It can also sometimes be caused by a decrease in oestrogen levels after the menopause.

Your GP may recommend using a local oestrogen and that is usually necessary with atrophy until the condition is more stable.

Unlike combined or other forms of HRT, thisonly restores oestrogen to your vagina rather than to your whole body, reducing the risk of side effects.

You can balance this additional oestrogen with bioidentical progesterone, and once the atrophy is under control you can use a combined bioidentical progesterone and oestrogen cream.

How to help yourself

There are number of self-help measures which can reduce the risk of these problems and help once they are diagnosed.

keep your genital area clean and drytake a warm bath rather than a hot one and useunperfumed soap to clean your genital area anddry yourself thoroughly

avoid douching (spraying water inside your vagina) it may make your vaginitis symptoms worse by removing the healthy bacteria that line the vagina and help keep it free from infection

do not use feminine hygiene products such as sprays, deodorants or powders

use pads rather than tampons if youre using intravaginal creams or pessaries to treat an infectiontampons may soak up the treatment meaning theres less available in the vagina

wear loose-fitting cotton underwearthis may be beneficial if you have external soreness, but it wont prevent you getting vaginitis in the future

Helpfulinformation:

Because women are often reluctant to talk about conditions like this, they do often suffer in silence but there really is no need as help is readily available.

Generally, maintaining good hormone balance with healthy levels of progesterone and oestrogen is a helpful measure too.

For any of these condition it is best topractice safe sex by usingcondoms to avoid getting or spreading sexually transmitted infections.

What Are the Symptoms of UTIs?

The rest is here:
Do You Have Dryness, Vaginal Atrophy or Vaginitis? - Bioidentical Hormone Health

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