Can changes in lifestyle improve menopause vaginal dryness?

Menopause can cause vaginal pain and dryness, this uncomfortable symptom is medically known as Genitourinary syndrome of the menopauses (GSM), it is a term that describes various menopausal symptoms associated with the vulva, vagina and pelvic floor region. It can make you feel unsexy and impact loving relationships. Be assured, there is plenty you can do to make this common symptom less painful. We’ve put together some self-help tips to improve your vaginal hygiene.

Looking for a holistic approach to improve menopause vaginal pain and dryness?

Vaginal pain is a perimenopause symptom no one talks about. It can impact relationships at a time when they may be strained by other life situations and symptoms such as low libido.

Our menopause advice for you and partners is don’t suffer in silence! 
Dyspareunia, or painful sex, in menopause is reported by almost 40% of women, most of whom don’t seek medical help or talk about it. Research by the Journal of Psychology, in 2017, found that relationships where sex is reported to be good, improved by 20% whereas those relationships with no sex declined by 70%. Women's Health Physiotherapist, Christien Bird, believes that with so many physiological, relationship and physical benefits attached, improving women’s enjoyment of sex by alleviating vaginal dryness, is essential. 

Talking to your partner about the big menopause picture and how vaginal dryness may be impacting on your sex life should help to calm fears that it's them, or your relationship, that’s the problem - rather than physical discomfort.

In our experience and at the events we run, women really enjoy and benefit from these frank, intense and often funny conversations.  Look around for a menopause mate who you can share experiences with. Discussing vaginal dryness may also encourage you to get professional help. Although it may feel overwhelming and embarrassing to talk to strangers about your sex life, as health professionals, they’ve heard it all before. Get advice from the GP in your practice that you feel most comfortable with or ask for a referral to an NHS Women's Health Physiotherapist or psychosexual counsellor. 

Wash and go! Intimate care products don’t always help.
Using warm water alone is the best way to wash your intimate areas but sometimes we want to use products to feel fresher. Avoid using normal shower gels and soap. There are specially formulated feminine intimate care products on the market but these are not generally recommended by specialist gynaecological health professionals.

You’ve always known you should use a good moisturiser! 
We know the importance of a good moisturiser on your face but what nobody tells you is that you can use one on your vagina. Yes, really. PH-friendly, products offer long-term relief for vaginal dryness. The 2015 NICE guidelines recommend using moisturisers and lubricants on their own, or in addition to, vaginal oestrogen to treat vaginal dryness. Creams or gels include:

• ‘Sylk Natural Intimate Moisturiser’, parabens-free, non-sticky with kiwi fruit extract, YES VM organic, parabens and glycerine-free moisturiser or ‘Replens’, along-lasting vaginal moisturiser. All available on prescription, to buy online or over the counter. Really worth talking to your GP or buying yourself.

The best lubrication for menopause vaginal dryness is…
Sex! Vaginal dryness may lower the chance that you’re going to feel like sex. However, the more sex you have, the more natural lubrication your body produces. Read our post about Intimacy, Intercourse and Menopause for some top tips to re-kindle your flames of desire.

How to relieve painful sex in menopause?
Because the tissue around your vagina is thinning, friction may make sex painful and could tear the tissue. As the shrinking vagina is less likely to produce moisture when stimulated, extra help may be needed. Lubricants can help relieve vaginal dryness during intercourse.  Try using: Sylk Natural Intimate Moisturiser, a water-based personal lubricant or the YES range of water-based and oil-based lubricants free from chemicals and irritants, which are particularly suitable for women who are sensitive to the glycerine or glycol in some lubricants.  Find out more about lubricants from our guest blogger, Lavinia Winch from the YES Company in her post lubricants for vaginal dryness.

Note: KY Jelly is often recommended by GPs as a lubricant to ease vaginal dryness, but it was developed to help internal examinations rather than as a moisturiser or lubricant. Many women find the chemicals it contains, vagina-unfriendly irritants. So best avoided.

Does laser treatment help menopause vaginal pain?
MonaLisa Touch is a laser treatment for vaginal atrophy. It has been approved by the FDA (the American food and drug regulatory body) and is available through private clinics here. However, it’s expensive (you need up to three treatments six weeks apart) and further controlled studies are required to confirm its effectiveness. 

However, if you’ve tried it, we’d love to hear what you thought about the treatment?

Non-HRT treatment for vaginal atrophy 
Tablets or pessaries such as Premeno Duo Vaginal Ovules can be inserted into the vagina. These non-HRT capsules are inserted before bed for an initial 10-day period and then every 3-4 days. The manufacturer says, ‘No-mess, colour or odour’. They may help improve moisture balance and strengthen vaginal walls. 

Vitamin E, an ingredient in many moisturisers, may help. Pop it as a pill, a pessary or apply directly as an oil to help repair damaged skin cells and promote skin cell moisture.

Physiotherapy advice for women’s intimate health

Women's Health Physiotherapist Christien Bird, says that painful sex is too common but not normal, she gave us 4 top tips to prevent painful sex.  Watch her talking with Positive Pause about Menopause & The Pain Of Sex.

Read all about it!

Me & My Menopausal Vagina: Jane Lewis' book urges women to be proactive about vaginal atrophy. You’ll find everything you want to know and more besides. As the review by Menopause Counsellor, Diane Danzebrink says “If you have a vagina, know or love somebody with a vagina, then you need to read this.”

What triggers dryness, pain and vaginal infections in menopause?

Menopause and thrush are common partners. A changing pH level in your vagina is normal during and after menopause. You may find that you are experiencing recurrent thrush during perimenopause. Depleting hormones contribute to a decrease in the mucus of your vagina, and the level of acidity also decreases, this can lead to other bacteria and fungi getting in, leading to you experiencing thrush and other bacterial infections.

What should you avoid to improve menopause vaginal dryness?

No scents

Avoid all scented soaps, detergents, fabric softeners and lotions. Ordinary scented soaps and shower gels can be astringent. And although you may be tempted to clean inside your vagina, due to the heightened smell caused when your vaginal alkalinity increases, only wash outside the vaginal area.

Ditch the douche

Vaginal douching removes the natural oils and lubricants from the delicate tissues, altering normal vaginal pH balance. These changes may cause thrush and urinary tract infections.

Lower sugar intake

Cut your sugar consumption because thrush and other infections love sugar. Try and remove it from your diet altogether as sugar is the devil in disguise for many of your menopausal symptoms, including vaginal pain!

If intercourse is painful and sleep is disturbed by night sweats, your urge to have sex with your partner may be low on your agenda. Do check our section on loss of libido to rekindle your desire.