Vaginal Symptoms

During the menopause many women experience vaginal dryness, itch, soreness plus many more symptoms. Women rarely discuss their vaginal health but it’s a vital part of a menopause consultation and we do ask these personal questions. If you have vaginal symptoms; especially dryness, having a cervical smear can be very uncomfortable or impossible. Many women say having sex can be very sore or they’re no longer able to have a sexual relationship. Most women have never talked to their GP’s and keep this highly personal issue to themselves; buying over the counter lubricants and moisturisers hoping they will work. Some of this may help but others don’t and in-fact can make vaginal symptoms worse. But how can you treat a condition when you don’t know the cause?

But what could this be?

Lack of Oestrogen, a vaginal infection, both? or could it be something else? When women go into the menopause and their female hormones fall; reduced oestrogen affects the cells within the vagina, pelvic floor and the bladder. The pH in the vagina changes causing a domino effect of changes. Vaginal dryness is very common and for most women vaginal oestrogens will replace all that lovely oestrogen, helping to restore the pH and symptoms will disappear. In addition; some women will benefit from vaginal moisturisers and lubricants. But what about vaginal itching?

But what else could it be?

A fairly common reason is Lichen Sclerosus (LS). We don’t know the cause but it’s believe to be an autoimmune disorder that changes the skin. The skin becomes inflamed and thickens; affecting the bottom layers of skin cells progressing to all cells and layers. If left untreated; the skin continues to thicken, the skin can fuse together affecting the clitoris, the vaginal opening or other parts of the genital and anal areas.

What does it look like?

The skin may look pale, white patches, (hypo pigmented), papery in appearance, look waxy and be very itchy. If LS develops to the vulva, any friction from having sex or using tissue could cause the skin to tear; leading to bleeding, redness and bruising. Scaring can then develop.

What can I do?

Firstly; it’s important to get a diagnosis. Any ladies we consult are advised to have a vaginal examination from their GP. If your GP thinks your symptoms are only caused by low Oestrogen, then either your GP or Bourne2care can continue to prescribe vaginal oestrogens and review its effectiveness. If you GP can see you have skin changes and thinks you may have LS they can prescribe steroid creams and ointments such as Clobetasone. You may need regular follow up and reviews as Steroids creams can’t cure the condition but can significantly reduce your symptoms. The creams/ointments will be prescribed; explaining the frequency and the strength of creams to be applied and to what parts of your genitals. It’s really important to continue to get reviewed by your GP or health professionals.

There can be a low risk of developing cancer from LS. This risk is low but this is why it’s important to have checks, follow up’s. If treatments aren’t working or your symptoms are worsening do talk to your GP. The more you understand the better. LS often goes into remission so when flare ups occur, discuss your treatment regimes with your health care professional.

Take Home Tips.

• Any changes mean something is different and you need to find out the cause.
• Most dryness and itch to the vagina are caused by lack of Oestrogen.
• Talk to your GP, Nurse Practitioner or Practice Nurse.
• Always ask to see a GP for a vaginal examination; this is the only way you’ll get an accurate diagnosis and treatment.
• Do tell your GP/Dermatologist if any symptoms aren’t improving or worsening.

If you’d like to book a private menopause consultation with Bourne2care and discuss your vaginal health please email enquiries@bourne2care.co.uk

For more information; please go to https://www.nhs.uk/conditions/lichen-sclerosus/