Why does lubrication decrease at menopause ?
Declining oestrogen levels after menopause reduce lubrication and gradually change vulval and vaginal tissues.
The vaginal mucosa becomes thinner, less supple and less hydrated. The vagina may also take longer to become lubricated during sexual arousal.
These changes may cause a sensation of dryness, burning, irritation or pain during intercourse. When associated with menopause, they form part of the genitourinary syndrome of menopause.
Unlike certain menopausal symptoms, these genitourinary manifestations tend to persist and may worsen without management.
What is the difference between a lubricant and a vaginal moisturiser ?
A lubricant is used during intercourse, whereas a vaginal moisturiser is applied regularly to reduce dryness between sexual encounters.
A woman who experiences discomfort only during penetration may mainly need a lubricant. A woman who also experiences dryness, burning or everyday discomfort may benefit more from regular use of a vaginal moisturiser.
Vaginal moisturisers are a non-hormonal option for mild symptoms of the genitourinary syndrome of menopause.
Does drinking more water improve vaginal lubrication ?
Drinking more water does not correct vaginal dryness caused by declining oestrogen levels.
Adequate hydration is necessary for normal bodily function, but increasing water intake does not directly restore the thickness, elasticity or hydration of the vaginal mucosa after menopause.
Persistent vaginal dryness should therefore not be interpreted simply as a lack of water.
What should be done when natural solutions are insufficient ?
When natural measures are insufficient to relieve menopause-related vaginal dryness, medical treatments may be offered.
Low-dose vaginal oestrogens are, in particular, among the treatments for the genitourinary syndrome of menopause. Their indication depends on symptoms, their intensity and the patient's medical history.
Vaginal laser treatment has also been studied for menopause-related dryness. Some women report improved symptoms after treatment.
When should you seek advice for vaginal dryness after menopause ?
A consultation is useful when dryness becomes persistent, causes pain during intercourse or is accompanied by other symptoms.
Burning, itching, unusual discharge, pain or bleeding must not routinely be attributed to menopause. An infection or vulval condition may cause similar symptoms.
Any vaginal bleeding occurring after menopause must be medically assessed.
A medical consultation determines whether discomfort is mainly associated with the genitourinary syndrome of menopause or another cause and guides appropriate management.
To improve lubrication without hormones, the most useful measures are therefore sufficient sexual stimulation, an appropriate lubricant during intercourse, regular vaginal moisturising and vaginal laser sessions.
Article written by Dr Valeria Romano
Dr Valeria Romano supports each patient with a comprehensive approach to the aesthetics of the face, body and intimate areas, and to skin and hair quality. Every treatment is based on a personalised medical assessment.
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