Menopause Mondays: Do You Know About Vaginal Atrophy?

Ellen Dolgen


Before we get to this week's post, I want to remind everyone that October is Breast Cancer Awareness Month. Towards my mission as a health and wellness advocate, may I make a simple request? If you are over the age of 40 and you haven't had a mammogram in the past year, will you schedule an appointment to get one before the end of this month? Early detection is so important. Unfortunately, many women over the age of 40 don't have annual mammograms. The National Breast Cancer Foundation has an online tool and smartphone app that you can use to create an early detection plan complete with reminders when it's time for self and clinical exams. How easy is that? Let's do this for ourselves, ok? And spread the word to the other women in your life.

Today's Menopause Mondays Blog was going to be a continuation of Ellen's 5 Steps to Hormone Happiness. Last week we learned Step 1: Don't Wait to get the help you need. This week's blog was intended to be Step 2: Find your Specialist. Please indulge me as I need to side step my plan a bit to be able to share with you some vital and exciting new research!

Got a Vagina? Know someone who does?

Is your vagina going through troublesome changes? If it was, would you be aware of it? Would you speak about it to anyone? Would you talk to your partner, lover, husband, or even your doctor about it?

Let me introduce you to Vaginal Atrophy (VA)! Is Vaginal Atrophy in your vocab? I think not! Although, almost 1 in 2 post-menopausal women suffer from Vaginal Atrophy, we would rather speak of flatulence, bad breath, incontinence and hemorrhoids than utter these two words. That's why I was excited and honored to have been flown to NYC to Co-Chair a Social Media Roundtable discussion along with Dr. Lauren Streicher, sponsored by Novo Nordisk on Vaginal Atrophy. Novo brought together an amazing group of committed health bloggers (for more info on these ladies, see below) who are devoted to disseminating information that helps empower women to have the knowledge necessary to help them lead happy healthy lives.

Novo Nordisk is an 89 year old global Danish pharmaceutical company, which prides itself in providing solutions for people with diabetes, hemophilia, children with growth hormone deficiency, and women experiencing the symptoms of menopause. At our roundtable, Novo revealed the results of their Partners Survey which is a part of a larger global survey titled the CLOSER Research (Clarifying Vaginal Atrophy's Impact On Sex and Relationships), which is aimed at better understanding the physical and emotional impacts Vaginal Atrophy has on intimacy and relationships, and to determine how to encourage positive conversations among men and women about this topic.

Vaginal Atrophy is a silent symptom of menopause that is defined as the thinning and inflammation of the vaginal wall that generally impacts women in their menopausal journey. VA occurs when there is a reduction in levels of estrogens which are produced by the ovaries. Estrogens are responsible for maintaining the structure and function of the vaginal wall, elasticity of the tissues around the vagina, and production of vaginal fluid. Just between us, until I began my own perimenopause and menopausal journey, the only lining I had ever concerned myself with was located inside my blazer! Thanks to Novo, I now understand the difference between a thick, healthy, well estrogenized vaginal lining vs. a thin, dry lining due to menopause - after estrogen loss. These vaginal and cellular changes are not pretty ladies! When it comes to the vagina - thin is out! VA can cause physical AND emotional challenges.

More than likely, since most of our mothers never sat us down and had a conversation about what to expect when you are expecting menopause, chances are she never uttered the words Vaginal Atrophy either. It is time to break the taboo and bust open up the conversation about the lining of our vaginas, because Vaginal Atrophy impacts all areas of a woman's life and affects the people who love us, tool!! Most women don't even know what VA is, nor understand that it is a chronic problem that requires ongoing treatment and IS treatable. Therefore, this is information that we must learn about and share with the sisterhood..

My motto is: Reaching out is IN! Suffering in silence is OUT! I want you to be VA experts so that you can be proactive about your health and NOT reactive. So let's get down to it:

What are the symptoms of VA?

  • vaginal dryness,

  • pain or bleeding in connection with sex (dyspareunia)

  • itching

  • soreness or irritation

  • painful or burning urination

  • incontinence (involuntary urination)

  • pain when touching the vagina

If you are experiencing any of the symptoms above, it could impact many facets or your life such as:

  • sexual intimacy

  • having a loving relationship with a partner

  • overall quality of life

  • feeling healthy

  • feeling attractive

  • feeling fit

  • exercising

  • traveling

  • participating in outdoor activities

If this is the case, why are women suffering in silence?

  • don't realize that VA is a common consequence of low estrogen levels

  • do not think there is help for sexual and vaginal health issues

  • are unaware of the treatment options

  • find short term solutions for relief instead of treating the underlying problem

  • believe that menopausal symptoms end when the hot flashes stop

It makes total sense that VA is going to affect your relationships, health, and over all feeling of wellbeing! According to the data, 35 percent of women reported they do not feel sexually attractive anymore and 31 percent had lost confidence in themselves as a sexual partner. It makes sense that all of this would lead to feeling isolated and alone and resulted in 24 percent reporting that they felt emotionally distant from their partners.

Let's face it ladies, if you found that suddenly sex hurts and you would rather scrub your kitchen floor than slip into bed with your lover - this would cause havoc with your relationships. The men in our lives are affected, too. The survey showed that 65 percent of men worried that sex would be painful for their partners, and almost a third of both men and women reported that they have stopped having sex with their partners altogether because of the discomfort.

So what's a gal to do???

1. Be sure you have a specialist that is going to be your partner in this menopause business. You can think of your doctor or nurse practioner as your business partner or your own personal chef who is going to create an individualized menu just for you! If you don't have a specialist definitely read next week's Menopause Mondays blog which will give you the tools that you need to find one! In the meantime, you can check out my Menopause Doctor Directory . The doctors listed here have been recommended by the sisterhood.

2. Ask for:

A pelvic exam to examine the pelvic organs; look at the vagina and the cervix.
A Pap test to take a sample of cells from the cervix. Get your vaginal secretions and the acid level in your vagina checked.
A urine sample might need to be included, if you are experiencing unusual urgency or a leaky bladder.

3. Talk with your specialist about the various options -systemic HRT, creams, vaginal ring, vaginal tablets etc. Listen to the facts and then together evaluate what is best for your individual needs. One of the options available is local estrogen therapy. I know that many women have completely closed off their minds to anything related to hormone therapy. Keep an open mind and listen to the latest information and data that was reported last week at the NAMS (North American Menopause Society) Annual meeting in Orlando. It is interesting to note that this CLOSER global research did find that compared with other countries surveyed, 77% of US women were most likely to use lubricating gels and creams, and are the least likely to use hormone therapy, despite the advantages shown in the survey among those who sought treatment. Of U.S. women who had tried local estrogen therapy (LET), 56% of women and 57% of their partners reported that sex was less painful, and almost 40% reported that sex was more satisfying for themselves and their partners. Since the use of LET, 34% of women and 54% of men look forward to having sex after using local estrogen therapy.

This leads me to be 100% positive that we should be talking about Vaginal Atrophy!

4. Communicate with your partner. When communication shuts down completely, everyone suffers, so it is important to keep talking. Don't be embarrassed - be open and honest. This will strengthen your relationships not hinder them.

This Social Media Roundtable opened my eyes once again to the tremendous need for women to break the taboos that still surround topics of great significance to our health and wellbeing. Vaginal Atrophy gets 250,000 Google hits compared to ED (Erectile Dysfunction) which has 34,000,000!

I am sending virtual hugs to Novo Nordisk for researching this "silent" symptom and pursuing science and innovation that will improve the lives of so many women and the people who love them. The CLOSER Research is an eye and mind OPENER!

Help me break the taboo and open up the conversation about Vaginal Atrophy. It is up to us to speak out and make sure that woman are educated, empowered, and determined to get the help they need and deserve.

Remember: Reaching out is IN! Suffering in silence is OUT!

Have you been checked for Vaginal Atrophy?

Novo Nordisk Social Media Roundtable:
My Co-Chair: Dr. Lauren Streicher
Meet the health bloggers extraordinaire:
Wendy Hoffman, Menopause: The Blog
Staness Jonekos, Menopause Makeover
Magnolia Miller, The Perimenopause Blog
Liz Scherer, FlashFree: Not Your Mama's Menopause
Susan Tolles, Flourish over Fifty
Shelley Zurek, Still Blonde After All these Years

Other helpful reading:

About the Partners' Survey and CLOSER Research

The Partners' Survey is part of a larger global online survey titled the CLOSER Research (CLarifying Vaginal Atrophy's Impact On SEx and Relationships). The research was sponsored by Novo Nordisk and conducted by StrategyOne (partnering with Ipsos MORI) between December 13, 2011, and February 7, 2012. The CLOSER Research survey was completed by 4,167 post-menopausal women, aged between 55-65 who had ceased menstruating for at least 12 months and have experienced vaginal atrophy and 4,174 male partners of post-menopausal women aged 55-65 who had ceased menstruating for at least 12 months and have experienced vaginal atrophy. The participants were located across nine countries: United States, U.K., Canada, Denmark, Sweden, Finland, Norway, Italy and France.

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