Vaginal Health and Menopause

By Betty Dolman, Pharmacist

People often think of Menopause as hot flashes, night sweats and mood swings, but there are many other changes that happen to a woman's body during menopause. Vulvovaginal Atrophy (VVA) includes all the changes that happen to the vagina and labia due to the deficiency of estrogen. Vaginal symptoms are highly prevalent and affects about 57% of post-menopausal women. Symptoms can include vaginal dryness, irritation, burning and painful sex. 

Symptoms of menopause such as hot flashes and night sweats, although bothersome, will typically resolve over time. VVA on the other hand, will get progressively worse without proper treatment. Despite this knowledge, VVA is highly under treated. 

During menopause, a women's estrogen levels will drop. One of estrogen's functions is to maintain healthy vaginal tissue. Low estrogen can cause thinning and drying of the vaginal mucosa. Along with the physical discomforts of dryness and irritation, VVA can have a significant affect on sexual health and quality of life. Some women report feeling less sexual, feeling old, negative effects on marriage/relationships and decreased self esteem.

The goal to treating VVA is to alleviate symptoms. First line therapies include vaginal moisturizers and lubricants. People often use these terms interchangeably, but moisturizers and lubricants have different intended uses. Vaginal moisturizers adhere to the vaginal lining and rehydrates the mucosa. It mimicks natural vaginal secretions to alleviate vaginal dryness. Moisturizers are longer acting and will last in the body for 2-3 days. They need to be applied regularly from everyday to every 2-3 days depending on the severity of atrophy. The majority of moisturizers contain water, a polymer to help the water adhere and other excipients to provide buffering, viscosity and preservation. 

Lubricants are fast acting and offer short term relief from vaginal dryness during sexual activity. There are many different products to choose from. Lubricants can be composed of a number of ingredients that include water, silicone, mineral oil or plant based oils. Water based products are generally non-staining and have fewer genital symptoms compared to silicone based products. Other ingredients are added to achieve viscosity, alter water activity and prevent bacterial contamination. 

With so many options, it is often hard to decide which product will be the most suitable for each woman. It is always a good idea to talk to one of our pharmacists  to help in choosing a suitable product and if needed we will work with your physician to compound a product specific to your needs.