Menopause and Genitourinary Changes

Let’s Talk About Menopause and Genitourinary Changes
This Blog follows on from my earlier Blog on Menopause.
Genitourinary changes as a result of menopause are rarely talked about by women. It can be a thorny subject and women may be embarrassed or uncomfortable to talk about what’s going on ‘down there’. They may feel it’s a private matter. We need to get better at talking about all the symptoms of menopause. The more we talk about it, the more normal these symptoms become.
Declines in female hormones impact on the genitourinary system causing chronic pain, irritation, urinary infections (UTIs), dry vagina, skin fissures, and fear of intercourse because of pain. While hot flushes and mood swings tend to settle with time, genitourinary changes don’t.
Sometimes symptoms are so bad women cannot wear jeans or tight clothes, or feel uncomfortable sitting down.
What’s Happening
Common symptoms of genitourinary changes include vaginal dryness, burning and/or itching around the vagina, painful intercourse, urinary incontinence, recurrent urinary tract infections (UTIs), and stress incontinence. The vaginal microbiome can change due to changes in pH of the vagina.
Anatomical changes can include a loss of fullness in the genital area, and weakened pelvic floor muscles.
Treatments
The good news is there is help available.
While there are pharmaceutical interventions for menopause symptoms, many women prefer a more natural approach such as medicinal herbs and nutritional supplements for the management of their symptoms. In my experience, around 95% of women who seek naturopathic help will benefit from the herbs and/or supplements prescribed.
Often a combination of oral and topical applications is appropriate.
A pH correct, water based lubricant can ease vaginal dryness and reduce pain during intercourse.
Vaginal creams based on medicinal herbs and specific nutrients can help.
A physiotherapist who specialises in pelvic floor problems can help with urinary incontinence, bladder weakness, weak pelvic floor muscles, and prolapse of the uterus. Correct diagnosis and treatment can provide relief of symptoms and confidence to get on with day to day life.
Entire Physio in Queanbeyan has a physiotherapist who specialises in women’s’ pelvic floor issues.
Personal care products can make symptoms worse e.g soap, bath gels, lubricants, condoms, panty liners or pads can all make symptoms worse. Use a low irritant soap, and stay away from anything that may irritate.
Talk to an accredited naturopath or herbalist to find out what medical herbs and supplements will suit your individual needs.
Vaginal Microbiome
No Blog on menopause is complete without discussion on the vaginal microbiome. The most prominent microbe in the vagina is Lactobacilli. As oestrogen declines so does the prevalence of Lactobacilli, leading to a change in pH. This in turn increases vaginal dryness and may decrease libido.
Changes in the vaginal microbiome during menopause have been implicated in chronic UTIs.
Probiotics taken orally and/or used as a pessary can assist in correcting the vaginal microbiome of menopausal women.
It’s essential you consult a qualified naturopath or herbalist before using probiotics as a pessary.
Seek Help
As difficult as it is to talk about genitourinary changes associated with menopause it’s important you seek help. There are sympathetic Naturopaths and Herbalists who will listen to your concerns and prescribe a suitable, personalized treatment plan.
If your own GP is hard to talk to, ask your female friends who they see. There are GPs and specialists out there who will listen to your concerns and help you.