Whether menopause is far in your future or a fact of your life now, it is important to understand how to care for your vaginal and vulvar tissue through menopause. There are things you should do to keep your body comfortable, functional and healthy. Vaginal care after menopause includes moisturizing, lubricating and stretching.

Hormonal changes result in specific recommendations for vaginal care after menopause.

The hormonal changes that accompany menopause include a reduction in estrogen, resulting in the mucous membrane of the inner labia and vagina getting thinner and drier, ominously called “vaginal atrophy.” This condition can cause discomfort and pain, especially with sexual activity. By moisturizing, lubricating and stretching, you can keep these effects at bay and you can continue to enjoy a thriving sex life as long as you want.

Step 1: Moisturizing

Moisturizing should be done 2 to 3 times a week. You can use Replens or KY Liquibeads, easily found at the drugstore or online. It is also possible to use the oil from vitamin E capsules, making sure it is pure vitamin E, and massaging it into the tissues. One other option is to use the Replens applicator filled with extra virgin olive oil, inserting the applicator into the vagina and expelling the liquid.  Do not use any other type of food oil for this use because they can trap bacteria.

Step 2: Lubrication

Vaginal lubrication is a normal function, resulting in wetness inside the vagina. Natural lubrication is reduced with menopause because it is supported by estrogen. Lubrication helps with penetrative sexual activity, but it also is important in keeping the vagina from getting too dried up, feeling itchy or painful, and getting small cracks. Vaginal dryness is often exacerbated by medications – like antihistamines and some antidepressants, among others. Using lubricants when dilating/stretching the vagina or when engaging in sexual behavior will help prevent the unwanted dryness. Lubricate the entire inner genital area – the inner labia (lips), the entrance to the vagina and inside. Make sure to use glycerin free lubes as these contribute to yeast infections.

Step 3: Stretching

Stretching is the third vital part of post-menopausal vaginal care. The vagina is a stretchy part of the body, typically accommodating what is inserted, but age, disuse and medical conditions or treatments can reduce the elasticity of the vagina. Regular stretching is important to reduce shrinking of the vagina and to increase the ease and comfort of vaginal penetration. Even if you do not expect or desire vaginal penetration, the vagina is an important part of your body that needs regular care and attention, and comfortable penetration is important for your annual pelvic exam, too. You can stretch the vagina gently with your fingers, with dilators (plastic rod shaped devices made for this purpose created in sets of increasing diameter) or with your partner.

 

My final comment on lifelong vaginal care regards bathing. Douching is not necessary, and in fact, it washes away your natural moisture and often irritates the tissues. Even soap can be too harsh for some women. Gently rinsing the area with water is sufficient.

 

Treat your vulva and vagina with care and attention, and you can enjoy a lifetime of healthy tissue and sexual pleasure.

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