A Gynaecologists’ Guide To Looking After Your Vagina

Collagen Levels Play A Part

“As we age, collagen levels fall and this can make the vagina feel less plump and paler in colour. You may also notice the vagina feels drier and tighter, which can make sex more uncomfortable. Declining collagen levels is also coupled with falling oestrogen levels post-menopause, which can lead to the vaginal tissue becoming drier and thinner. This, in turn, can contribute to a lack of libido, which is also common during the menopause. With less lubrication and thinner tissue, sex can often feel uncomfortable and in some cases be painful. You may also experience some breakthrough bleeding after sex. If you experience any physical or emotional changes which cause you concern, always chat to your GP or gynaecologist. With the right help there’s no reason why you can’t enjoy sex in your 50s and well into later life.”

A Yeast Infection Can Easily Go Unnoticed

“Thrush may be associated with younger women but can still happen as we get older. In fact, a yeast infection can mimic the symptoms of vaginal atrophy but is actually caused by a fungal infection. By comparison, vaginal atrophy is generally caused by a lack of oestrogen. At the same time, there is plenty you can do to avoid getting a UTI, which can become more common with age as they are linked to diabetes and kidney problems. Try to empty your bladder completely after sex, and always sit with your feet supported when on the loo, taking care not to strain. Once you have finished, stand up and move around for a few minutes, and then return to the loo and try to pass some more urine.” 

Visit MyHealthCareClinic.com

Your Pelvic Floor Will Be Weaker

“After menopause, the toll of pregnancy and childbirth become apparent. Carrying a pregnancy and going through labour damages the internal support structures of your pelvic organs, which are supported by a sling of muscle collectively known as the pelvic floor. Once these muscles have been weakened, the pelvic floor cannot support the uterus, bladder and bowels as it should, and you may notice a variety of symptoms. The problem is exacerbated at menopause by oestrogen deficiency and is also made worse by weight gain. It’s never too late to start doing pelvic floor exercises. Some physios also recommend the use of Kegel weights, which are inserted into the vagina – you exercise your pelvic muscles by trying to stop them from falling out.”

Prolapse Is Common

“A prolapse occurs when the vaginal walls, cervix, uterus, bladder and/or the bowels descend lower into the pelvis than they should. Symptoms include becoming aware of a bulge or a lump down below, urinary symptoms such as needing to pass urine frequently and getting up at night to pee, having to pee right away and/or faecal incontinence. In the most severe cases, the uterus can prolapse completely and hang outside the vagina – this is called a procidentia. NICE reports that 8.4% of women complain of feeling a bulge or lump down below, of whom 50% are found to have a prolapse. One in ten women require some form of surgery and 19% need a repeat operation. It’s tricky to prevent prolapse – to some extent it’s the price women pay for pregnancy, childbirth and the menopause, but you can reduce your chances by staying fit and active, maintaining a healthy weight and eating a healthy diet with lots of fibre to prevent constipation, which can put pressure on the pelvic floor.”

Topical Oestrogen Can Help

“After menopause, up to 70% of women suffer from vaginal atrophy – symptoms include itching, irritation, pain passing urine, feeling sore, painful sex and post-coital bleeding. However, there is no need to suffer in silence and the condition can be treated with local vaginal oestrogen. This is a low-dose, natural oestrogen, chemically identical to the oestrogen your body used to make pre-menopause. It’s not the same as taking formal HRT – it’s applied directly into the vagina as a cream. Over time, this thickens the vaginal cells so moistness and plumpness increase. Almost no oestrogen is absorbed into the bloodstream and it’s suitable for almost everyone, even women who are taking conventional HRT tablets/gel or patches. The most well-known brands are Ovestin cream and Vagifem pessaries.”

Menopause Shifts The Balance

“Low oestrogen levels in the body can alter your vaginal pH. A healthy vagina has an acidic pH of between four and five. After menopause, fewer lactobacilli produce lactic acid, hence the pH rise, so the vagina becomes more alkaline. In younger women, it’s the natural acidity of the vagina that helps prevent microbial overgrowth so, after menopause when this acidity is disturbed, women become more prone to episodes of bacterial vaginosis (BV). BV is a very annoying condition, in which women develop a foul smelling, fishy discharge. It can be treated with antibiotics, either orally or local application of clindamycin cream.”

Visit DoctorFox.co.uk

Ageing Can Increase The Risk Of UTIs

“In young to middle-aged women, the prevalence of UTIs is less than 5%, rising considerably with age. In fact, studies have shown 15-20% of 65-70-year-old women have bacteriuria (the presence of bacteria in the urine), compared with 20-50% of women above the age of 80. Most UTIs can be easily treated with a round of antibiotics, however only symptomatic cases need treatment – look out for a burning sensation when peeing, peeing more than usual, an urgent need to go to the loo, blood in your urine or pain above the pubic bone. If you don’t have these symptoms, it may be asymptomatic bacteriuria. Vaginal oestrogen creams show great results in preventing UTIs in post-menopausal women and, while alternative methods like drinking cranberry juice and taking the lactobacilli form of probiotic can also help, more research is needed on these.”

Visit ByQuanna.com

Post-Menopausal Bleeding Can Be A Warning Sign

“More than 90% of women with endometrial cancer experience post-menopausal bleeding and 9% of all post-menopausal bleeds are related to the disease, so always let your GP know if you’re experiencing any form of bleeding. Every year in the UK, 9,200 women are diagnosed with endometrial cancer. It’s very rare in women under 40 but becomes more common post-55, with obesity and inherited risk being key risk factors. Fortunately, the majority of endometrial cancers are found in an early stage and have a very good prognosis.”

It's Never Too Late To Get A Smear Test

“Cervical screening stops at 64 as it takes between 10-20 years for HPV to develop into abnormal cells, and then into cervical cancer. This means it’s unlikely those who have been regularly screened will go on to develop the disease. However, if you are over the age of 64 and have never had a cervical screening, or haven’t had a screening since you were 50, then you are still eligible, so chat to your GP if this is the case. Along with bleeding, common symptoms of cervical cancer include unusual discharge and pain during or after sex.”

Smoking Is A Risk Factor

“Rarer than other types of gynaecological cancers, vulval and vaginal cancers affect 1,400 and 250 women respectively in the UK each year. Between 40-50% of vulval cancers are found in women over 70 and most vaginal cancer cases are in those over 60. For both, symptoms include abnormal pain and bleeding, and smoking and HPV increases the risk of developing these diseases. Other signs of vulval cancer include a lump, a rash that doesn’t go away or an unusual mole. It can also be caused by vulval intraepithelial neoplasia (VIN), a very easy to treat skin condition.”

Visit RoyalMarsden.NHS.uk/Private 

DISCLAIMER: Features published by SheerLuxe are not intended to treat, diagnose, cure or prevent any disease. Always seek the advice of your GP or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programme.