1 in 3 have been too embarrassed to go to the doctor

Q Why is vaginal dryness a problem after menopause? A OESTROGEN HAS A MOISTURERETAINING EFFECT ON THE SKIN,

AND THIS MEANS THAT AFTER THE MENOPAUSE THE SKIN DOES BECOME NOTICEABLY DRIER AND THINNER – NOT

ONLY IN THE MORE OBVIOUS PLACES, LIKE YOUR FACE, BUT ALSO IN THE NOT-SOOBVIOUS, ESPECIALLY THE GENITAL AREA. IT’S A CONDITION KNOWN MEDICALLY AS ATROPHIC VAGINITIS. NOT ONLY THIS, BUT OESTROGEN ALSO PLAYS AN IMPORTANT PART IN MAINTAINING THE GLANDS THAT PRODUCE LUBRICATING FLUID WHEN YOU

ARE SEXUALLY AROUSED. THIS MEANS

THAT WOMEN NOTICE THAT SEX IS DRY

AND UNCOMFORTABLE, NO MATTER HOW MUCH FOREPLAY YOU HAVE. AND BEING HONEST, EVEN FOREPLAY CAN BE DIFFICULT TOO. BECAUSE AGAIN THE TISSUES FEEL DRY, THERE IS A SENSATION OF HARSH RUBBING RATHER THAN STROKING. OTHER SYMPTOMS INCLUDE THE VULVA FEELING A BIT ITCHY AND SORE, WHICH MANY WOMEN MISTAKE FOR THRUSH. BUT USING ANTI-THRUSH TREATMENTS NOT ONLY DOESN’T HELP AT ALL, BUT CAN MAKE THE DISCOMFORT WORSE. SOMETIMES THE DRYNESS IS SO EXTREME THAT IT LEADS TO INFLAMMATION, WHICH CAN CAUSE SLIGHT BLEEDING OR A VAGINAL DISCHARGE. A DRY, INFLAMED VULVA AND VAGINA

ARE ALSO AT INCREASED RISK FROM INFECTION FROM ORGANISMS FROM AROUND THE ANUS. THE CHANGE IN THE GENITAL TISSUES CAN ALSO INCREASE THE RISK OF URINARY PROBLEMS, PARTICULARLY URINARY TRACT INFECTIONS. Q Are oestrogen pessaries or creams safe? A THESE ARE DESIGNED TO BOOST OESTROGEN LEVELS IN JUST THE GENITAL TISSUES. THE AMOUNT OF OESTROGEN THAT REACHES THE REST OF THE BODY – PARTICULARLY THE BREASTS – IS MINISCULE, AND THERE IS NO EVIDENCE THAT USING THEM IS ASSOCIATED WITH AN INCREASED RISK OF BREAST CANCER. THERE IS, HOWEVER, A THEORETICAL POSSIBILITY THAT THEY COULD STIMULATE SOME GROWTH IN THE LINING OF THE WOMB, AND IN THE PAST, IT WAS RECOMMENDED THAT WOMEN USING THEM HAD OCCASIONAL COURSES OF PROGESTERONE TO COUNTERACT THIS. THIS IS STILL THE CASE WITH THE SLIGHTLY HIGHER DOSE OESTROGEN CREAMS, BUT IS NO LONGER THOUGHT TO BE NECESSARY WITH THE LOWER DOSE OESTROGEN PESSARIES. Q I don’t want to use any hormones… what can I do to help our love life? A USING A SPECIAL GEL OR CREAM THAT HELPS TO BOOST MOISTURE LEVELS IN THE SKIN OF THE GENITAL AREA, SUCH AS VAGISAN MOISTCREAM, CAN MAKE THE GENITAL AREA FEEL MORE COMFORTABLE. BECAUSE THE GLANDS THAT PRODUCE

EXTRA LUBRICATION WHEN YOU ARE AROUSED DO NOT WORK SO WELL POST-MENOPAUSE, BY USING HORMONE-FREE VAGISAN MOISTCREAM ON A REGULAR BASIS YOU DO NOT HAVE TO USE A LUBRICANT EVERY TIME. IF YOU ARE IN A NEW RELATIONSHIP, YOU NEED TO TAKE PRECAUTION AGAINST CATCHING AN STI, SO CHECK THAT WHATEVER PRODUCT YOU USE DOES NOT HARM THE RUBBER USED IN CONDOMS.

HRT and hormone-free moisturising creams can both help to relieve vaginal dryness