Vaginal dryness, incontinence, painful sex? Sex & Relationship Expert Miranda Christophers, reveals the impact of intimate menopause symptoms, plus what can help
October is Menopause Awareness Month, and the topic of menopause has never been hotter.
Hot flushes, night sweats, anxiety, low mood – the discussion of these well-known symptoms of menopause have been prevalent in the media in recent times, signalling a huge step forward for women, who in the past have had to suffer their symptoms in silence.
However, although menopause awareness continues to grow and the taboo slowly diminishes, many are still unaware that beyond these common symptoms, lie a whole load of other symptoms that are less frequently spoken about, yet just as debilitating.
approximately 60% of women experience intimate health symptoms (Urogenital Symptoms) during menopause
Intimate health symptoms that appear during the menopause are widely unknown, with menopausal women not realising that their sexual health issues are directly caused by the hormonal changes of menopause.
In fact, approximately 60% of women experience intimate health symptoms (Urogenital Symptoms) during menopause, according to the National Library of Medicine.
These symptoms include:
- Vaginal dryness: making penetrative sex uncomfortable or painful (dyspareunia).
- Reduced sex drive: due to decreased hormones.
- Urinary incontinence: due to changes to bladder tissues and pelvic floor muscles.
- Mood changes: can cause you to feel too stressed or emotional to enjoy sex.
Indeed, the most frequently reported intimate health symptoms include, low sexual desire (40 to 55%), poor lubrication (25 to 30%) and dyspareunia (12 to 45%).
‘Sexual health and intimacy are important to consider during the menopause transition period,’ says Sex & Relationship Expert, Miranda Christophers.
‘It’s important because people should be able to enjoy the intimacy and sex lives that they would like to have.
‘What we understand in terms of relationships is that sense of closeness, understanding and communication is vital, and for many people, intimacy on some level matters hugely to them, whether that be physical intimacy or sexual intimacy.’
Sexual health changes during menopause
During menopause, there are physical changes happening to your body as well as hormonal changes.
Within the vulva and vaginal area, the physical changes include thinning, shortening of the vagina and narrowing of the vaginal walls.
Also, there is a reduction in elasticity and thinning of the skin, which can affect the external area of the vagina and the vulva also. Because of this, some women find that they can get tears, some bleeding and discomfort.
Some women do find that they can experience changes in terms of their sensation, desire and orgasm
Other symptoms include an increase in the likelihood of Urinary Tract Infections (UTIs) and an increase in bacterial vaginosis, due to changes in acidity in the vagina.
‘Some women do find that they can experience changes in terms of their sensation, desire and orgasm as they go through the menopause,’ reveals Christophers.
‘This affects people differently, but it can be the case that you notice a decrease in sensation and that it is harder to get to that point of orgasm than you had previously.’
Reduced sex drive and low mood
‘During menopause, our hormones fluctuate, and oestrogen starts to decrease, which is the main reason for changes in sexual desire,’ explains Christophers.
‘Another factor is a change in mood. You may notice you are not feeling up for sex as much as you did previously, you could be feeling anxious or stressed about having sex, or you may feel that you lose your temper more often.
‘This is something that a lot of women report during menopause, which often affects how you feel sexually towards your partner.
‘I talk to people in therapy often on how a loss of libido has impacted their relationships, but also their sense of self.
‘It is difficult to come to terms with a change in sexual desire when previously you were used to regular sexual intimacy.’
you could be feeling anxious or stressed about having sex
Another thing to consider during menopause, is how physical changes of menopause can impact your self-esteem and confidence.
‘The body changes during menopause, you may notice your weight fluctuating, or your shape changing,’ explains Christophers.
‘Body image issues are something I see a lot of in in therapy, with many coming to talk about to me about these issues affecting their libido and sex life during the menopause.
‘We need to consider that there are a variety of different things that can affect the way somebody is feeling emotionally in terms of going into sexual intimacy.
‘If you do not feel good about yourself – how you look or feel – it’s going to affect your confidence, self-esteem, and relationships, which in turn has an impact on your libido.’
READ MORE: A gynaecologist’s guide to painful sex
The female sex hormone oestrogen is responsible for keeping the vagina lubricated and maintains vaginal wall tissue.
But as we know, during menopause and the years leading up to it (perimenopause), oestrogen levels can fluctuate and then dramatically drop.
oestrogen is responsible for keeping the vagina lubricated
The amount and type of vaginal discharge we make can also change, the vagina and the surrounding skin may look paler and the bacterial balance in the vagina may also change.
As a result, women may experience vaginal dryness and tightening. This can cause penetrative sex to become increasingly painful (dyspareunia).
Bladder function can also be affected during menopause, with urinary leakage or ‘accidents’ becoming more common.
These symptoms can have a massive impact on the quality of sex, pelvic floor health, your relationships, and the quality of your life overall.
In fact, up to 40 per cent of women at some stage will experience urinary incontinence.
The most common form is stress incontinence – leaking urine with coughing, sneezing, or exercise.
‘This can affect confidence more than anything else, as it can feel uncomfortable and may be embarrassing,’ Christophers explains.
‘Sadly, people often admit that they avoid certain social situations and events due to urinary incontinence.’
So, what can help mitigate the intimate health symptoms of menopause?
Communication is key
‘My advice to anyone going through these types of symptoms associated with menopause is to think about communication in the relationship and what is happening to you – try and educate yourself,’ says Christophers.
‘You may have a partner who doesn’t fully understand the menopause, so it’s a good idea to help educate them too, as being able to have sincere heart to heart with your partner about what you are experiencing is key.
try to focus on general intimacy and keeping the communication channels open
‘Even if sexual intimacy feels like it’s on hold for a while (because of desire or pain,) then try to focus on general intimacy and keeping the communication channels open.
‘Maybe it’s having regular date nights, spending quality time together, taking up new interests and really being explorative with each other.’
Lubricants and sex toys
‘I also recommend introducing lubricants, as this can help increase sensation and sensitivity, but also helps lessen the amount of discomfort felt from vaginal dryness.
‘Sex toys are also a great idea to use alone or with your partner, as arousal moves blood around the genital organs, which helps keeps tissues oxygenated and healthy.
‘Sex toys can be used externally if you prefer, focusing on the clitoral stimulation to reduce any discomfort anywhere else.’
Device-based treatments for ‘vaginal rejuvenation’
Device-based treatments are available, and are aimed at resurfacing vaginal tissue, with the objective to reverse vaginal dryness and tightness, caused by hormonal fluctuations.
Menopause brand Issviva partnered with leading expert Joylux, to create introduce the first non-invasive device (pictured above) that uses light technology to rebuild collagen and elastin to tighten and rejuvenate the vaginal tissue.
The Issviva x Joylux Vaginal Rejuvenation Device, uses a unique combination of light energy from red and infrared light-emitting diodes (LEDs), thermal heat, and therapeutic vibration to help rebuild collagen to improve vaginal tissue laxity.
When red and infrared light technology are applied together to tissue, our mitochondria (the brain of our cells) is activated and releases two chemicals: ATP (the energy of cells) and nitric oxide.
the first non-invasive device that uses light technology to rebuild collagen and elastin to tighten and rejuvenate the vaginal tissue
ATP increases the natural production of collagen and elastin, while nitric oxide increases blood flow, leading to greater circulation and tissue repair.
Together with light, vibration improves the delivery of the light energy into the tissues. Vibration also has a positive correlation with vaginal health, stimulating fibroblasts, a type of cell that contributes to the formation of connective tissue.
The device heats the vaginal tissue to 40-42°C, which helps to alter localised collagen. The device then takes these collagen fibres and re-tightens the tissues within the vagina.
The device is used intra-vaginally for ten minutes every other day and results are experienced from six to twelve weeks, after which there is an ongoing management programme to ensure that the area remains toned, vascularised and working effectively.
A number of clinical studies have shown the effectiveness of this ground-breaking device.
One such study showed that the Issviva x Joylux Vaginal Rejuvenation Device causes an increase of glycogen and thickening of the tissue covering the internal surfaces of the body (epithelium).
This helps maintain the pH of the vaginal tissue, which prevents Urinary Tract Infections, that are more common in menopausal women.
77 per cent of women saw an improvement in sexual function
Women also reported they were naturally more lubricated, due to an increase of blood flow to the tissue.
Another study revealed that 77 per cent of women saw an improvement in sexual function, 55 per cent no longer experienced any stress incontinence, and a whopping 90 per cent recorded increased sensitivity and sexual pleasure.
The clinical proven results therefore show that the Issviva x Joylux Vaginal Rejuvenation Device is an all-in-one aid for many of the intimate health symptoms caused by the menopause.
So, if you’re looking for vaginal tightening, improved bladder function and increased lubrication, as well as improvements in quality of life, self-conﬁdence, and sexual function then this device is an investment worth making.
Miranda Christophers is an Accredited Psychosexual and Relationship Therapist, and Lecturer on an Advanced Diploma in Relationship Therapy. She works with individuals and couples to help work through issues affecting their relationships, self-esteem, confidence, and sex lives. In addition to providing therapy, she is an ambassador for Issviva Menopause, and is a regular media contributor to newspapers, magazines, podcasts, and radio.
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