In my experience working in women’s health, I’ve seen that vaginal dryness and atrophy are significant concerns for women in midlife. Around 75% of menopausal women report experiencing vaginal dryness, but it’s not an easy topic for women to discuss openly.

FACT: During perimenopause and menopause, the drop in oestrogen shakes things up. Your pelvic floor, bladder lining and urinary tract can get weaker as a result, causing UTI´s, overactive bladder and stress or urge incontinence, pelvic organ prolapse and Vaginal Dryness!!!!

The primary culprit behind vaginal dryness and atrophy is low oestrogen levels. Oestrogen is essential for maintaining blood flow to the vagina, improving its lining’s thickness and elasticity, and keeping it moist and sensitive for arousal.

However, oestrogen isn’t the only hormone affecting vaginal health. DHEA (dehydroepiandrosterone) also plays a crucial role. DHEA is a precursor hormone for oestrogen and testosterone, so optimal levels of DHEA are necessary for overall hormonal balance.

When hormone levels are not optimal, vaginal dryness and atrophy can occur, leading to pain and discomfort during sex. Additionally, vaginal atrophy can cause irritation around the urethral opening, leading to bladder symptoms like urgency, frequency, and disrupted sleep due to nighttime urination.

What´s a girl to do??

Restoring Vaginal Health During (Peri) Menopause

To promote vaginal health during menopause and beyond, it’s essential to establish a strong foundation for hormone balance. This includes prioritising consistent, quality sleep (despite nighttime urination), adopting a real-food diet low in sugar, minimising exposure to hormone-disrupting chemicals, addressing nutrient deficiencies with supplements, and incorporating regular exercise to support hormonal well-being. Stress management is also crucial, as elevated stress levels can significantly impact hormone health.

Certain supplements like ground flaxseeds, fermented organic soy, black cohosh, and maca may help boost overall oestrogen levels in some women.

However, as hormone levels naturally decline over time, additional interventions may be necessary. Here are some targeted remedies:

Over-the-Counter Solutions:

1. Vaginal Lubricants and Moisturizers: While these provide short-term relief for vaginal dryness during sex, they are often seen as temporary fixes and do not address the underlying hormonal decline.

2. DHEA-Containing Vaginal Creams: Can rejuvenate vaginal tissue.

3. Bezwecken Vaginal “Cubes”: Bezwecken offers vaginal formulations that focus on rehydrating vaginal tissue, with some containing DHEA for deeper effects.

4. Low-Dose Vaginal Estriol Preparations: Look for organic, reputable creams containing estriol to apply externally around the vagina, including the labia, clitoris, and vaginal opening, following manufacturer instructions for safe use.

These targeted remedies can help alleviate vaginal dryness and discomfort, especially when coupled with holistic lifestyle changes to support overall hormonal health.

Prescription Solutions for Vaginal Health

1. Prescription-Strength Oestrogen: Is available by prescription and can significantly improve vaginal dryness and other menopausal symptoms. Vaginal oestrogen comes in various forms like rings, tablets, and creams, targeting the vagina directly to restore its health.

2. Topical DHEA: Unlike oral DHEA, topical DHEA has shown effectiveness in reducing vaginal dryness, improving pH balance, strengthening vaginal muscles, reducing pain during intercourse, and enhancing sexual arousal and libido. This treatment requires a prescription from a hormone specialist.

3. Testosterone Replacement: Optimal testosterone levels are crucial for vaginal, bladder, and urethral health. Testosterone supplementation can reduce nighttime bathroom visits, urinary leakage, and urgency, while also boosting libido. Testosterone is available by prescription from a healthcare provider experienced in hormone therapy. Despite common misconceptions, all women will experience a decline in testosterone over time, often leading to vaginal discomfort, making testosterone replacement a potential solution.

Thanks for reading.

Louise xx

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