How can I deal with vaginal changes during menopause?

In menopause, many women experience vaginal changes such as dryness, itching and pain during intercourse. These changes occur because the tissue that lines the vagina is responsive to estrogen, which your body starts making less of as you go through menopause. One possible treatment includes replacing the missing estrogen with a topical cream or suppository in the vagina. Using a water-soluble lubricant can also help with dryness or pain during sex. It’s a good idea to have a discussion with your doctor if you are experiencing vaginal symptoms to determine if they are due to menopause or a different cause, so you can get appropriate treatment.

Menopause brings many changes, and one of the peskiest is a change in the way your vagina feels. Vaginal changes can lead to itchiness, dryness, irritation (which can even lead to bleeding) and trouble with intercourse.

It's time to be proactive. Here's what you need to know:

  • Stop using soap on the inner parts of your vulva; clean water is adequate for washing.
  • Use only white, unscented toilet paper.
  • Wash your underwear in detergents free of dyes and perfumes.
  • Avoid fabric softeners.
  • Stay away from using lotions and perfumed products on the inner vulva.
  • Avoid douches and bubble baths.

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Estrogen loss leads to the drying and thinning of the vaginal walls, as well as a decrease in vaginal lubrication. These changes result in itchiness and painful sexual intercourse in up to 45 percent of menopausal women. Oral hormone replacement therapy (HRT) or vaginal estrogen creams or suppositories can ease symptoms for most women.

Various moisturizers (e.g., Replens) also are available without prescription. These not only moisturize but also increase vaginal elasticity. A prescription insert, Intrarosa (prasterone), may relieve the problem. Regular sexual intercourse or self-stimulation also may improve vaginal lubrication over time, with or without estrogen replenishment.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.