If you are a woman who is approaching menopause, you likely have some questions about what's in store — not because menopause isn't talked about (I think we've all seen one too many rom-coms with a female lead going through "the change"), but because it is often discussed in one of two modes: abstract or hyperbolic.
The reality is menopause can be different for every woman. Sure, there are some generally universal side effects such as hot flashes that most women experience during this time — they're a cliché for a reason. But there are also many changes women heading into menopause simply aren't aware of, and many of these changes happen to your vagina.
Curiosity piqued? Here are a few you probably didn't realize menopause could do to your nether regions.
Vaginas are like snowflakes (that's a lovely metaphor, eh?) — no two are alike. So, naturally, color variation from woman to woman is normal. There isn't a standard color the vagina is supposed to be, and the color you start with might not even be the one you end up with. According to Dr. Michael Krychman, M.D., gynecologist and executive director of the Southern California Center for Sexual Health, decreased estrogen during menopause can cause a woman's vagina to become lighter or duller in shade than it was prior to menopause.
Well, sort of. Dr. Hope Ricciotti, M.D., a gynecologist and Harvard Medical School professor, shuns the stereotype that a woman's vagina basically shrivels up during menopause. However, she does explain that the vaginal canal (and its entrance) may narrow during menopause due to decreased estrogen and blood flow — especially for women who aren't having sex on a regular basis. "The vagina is a 'use it or lose it' place," she told Woman's Day. "The act of having intercourse stimulates blood flow to the vagina and keeps it healthy."
Remember how we were talking about declining estrogen levels during menopause? According to Dr. Nancy Phillips, M.D. and Gloria Bachmann, M.D., this estrogen reduction can cause the tissues of the vagina, clitoris and labia to become more delicate and thin. This can lead to pain during sex for some women.
The aforementioned thinning can then lead to dryness, which in turn leads to inflammation. So, admittedly, this part's not the greatest. But not all women experience the symptoms of vaginal atrophy during menopause, meaning it's possible this won't be an issue for you at all. However, if it is, you could experience vaginal burning, discharge, dryness and itching, as well as urinary urgency and other inconveniences. There are treatments available to address certain symptoms, though.
Not only does the tissue in your vagina thin during menopause, but that tissue also becomes less acidic. The University of California at Berkeley links these changes to a possible uptick in vaginal odor during menopause. Typically, they cite, women report a smelly, watery discharge. And although discharge is a totally normal byproduct of the vagina, particularly pungent discharge should always be addressed by a doctor to rule out infection. Fortunately, topical estrogen may nip this problem in the bud for menopausal women.
Oish, I know — nobody wants to hear this one. However, the physiological changes we've been talking about (especially reduced blood flow to the region) mean the menopausal vagina may not be as conducive to climaxing. "You may be used to 30 orgasms a night, but the reality is that during and after menopause, you may have to work a little harder to have one or two," says psychologist and sex educator Dorree Lynn, Ph.D.
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