Vaginal Changes During Perimenopause, Menopause, and Beyond

Vaginal Dryness

Decreased lubrication, dryness and itching are often the first signs of change noticed during perimenopause or after hysterectomy surgery. This dryness is due to diminished blood flow to the vaginal walls, fewer cells lining the walls, less mucus produced by the cervix, and less fluid in general. Without the usual moisture, the vagina fails to lubricate properly during sexual arousal and intercourse, which may result in difficult or painful sexual relations. It is estimated that at least 50 percent of women over 60 have some degree of vaginal dryness. The good news is that regular sexual intercourse actually helps keep the vagina moist and toned.

Thinning Skin

As estrogen continues to decline and menopause occurs, the vaginal walls become thinner, less elastic and pale in a process called atrophy. The stretchy wrinkles that provided the expansion required for childbirth smooth out and disappear. The thin, less flexible surface can be easily irritated during intercourse, especially if it is infrequent.

Change in pH level

The loss of estrogen also produces a change in the vaginal pH from a normally acidic low to a higher, more alkaline pH. This less acidic environment discourages the growth of important protective organisms such as lactobacillus, which act as a bacterial guard against abnormal bacteria and yeasts. In the absence of lactobacillus, bacterial vaginal infections may occur more frequently, causing discharge and irritation, and contributing to increased urinary tract infections.

To help maintain a healthy balance between yeast and bacteria, many health professionals recommend probiotic supplements such as Florajen Acidophilus with 11 billion beneficial bacteria including acidophilus in each capsule.

Thinning of Other Tissues

Since estrogen has a major role in maintaining the health and function of not just the vagina, but all tissues including the uterus, urinary bladder, and urethra, low levels of the hormone may cause these organs to weaken and shrink. When the bladder is affected, urinary incontinence, infection or painful urination may occur.

Managing Changes

Get the essentials you need to manage your Vaginal Health symptoms with our Vaginal Health Essentials Collection.

Non-prescription options include our advanced formula topical Vaginal Moisturizing Cream with phytoestrogens, which combines natural ingredients that promote comfort and health for sensitive vaginal tissues.

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Water-based lubricants such as Astroglide are also options to consider. Astroglide Personal Lubricant provides light lubrication for enhancing the comfort and ease of intimate activity.

Prescription Options

Prescription therapy is also available with options beyond traditional hormone therapy. Low dose vaginal creams, tablets, and suppositories are suggested for their localized effect. These treatments can help alleviate vaginal dryness, itching and discomfort, and slight incontinence.