How to support your vaginal health during menopause

You wave the kids off to school, feel your shoulders relax a little and then head to the kitchen for a cup of coffee. But, as you’re sitting down you notice that your usually comfy knickers feel tight and itchy, or is your vagina that doesn’t feel quite right?

Many women in menopause transition can experience a variety of symptoms such as hot flushes, night sweats, weight gain and cognitive concerns. But one area that isn’t discussed as much is vaginal health issues, which are both painful and inconvenient. For some women recurring vaginal infections are making their lives utterly miserable.

During menopause, the female genitourinary tract (the vagina, vulva, urethra, and bladder) can also become affected, largely due to the decline in oestrogen. Which can leave our vaginas feeling uncomfortable, sore, dry, itchy and at a greater risk of infection.

What happens to our vagina during menopause?

When we’re younger, we have an abundance of oestrogen and this helps support vaginal health as it ensures our vaginal tract remains acidic, making it a difficult environment for certain bacteria to take hold and cause infections. However, as our oestrogen levels start to decline, it makes us more susceptible to vaginal and urinary tract infections (UTIs).

Not only is our vaginal microbiome (bacteria) changing, but reduced levels of oestrogen can also result in vaginal atrophy which means our vaginal walls become dryer, thinner and inflamed. Vaginal atrophy can make intercourse painful and exacerbate uncomfortable urinary symptoms.

Taking care of our pelvic health is essential for living well, during and after menopause.

Pelvic health support during the menopause

The most abundant vaginal bacteria in women are Lactobacilli, these bacteria produce lactic acid which acidy the vaginal environment and lower the pH, this creates an unfavourable environment for any potential bugs or infections to thrive.

During menopause, our lactobacilli decline, which in turn increases the pH of our vagina. This leaves us at a greater risk for recurrent UTIs, thrush, cystitis and bacterial vaginosis. Studies show that probiotics during menopause can be beneficial in supporting our genitourinary health, as they help repopulate the vaginal tract with lactobacilli.

However, different probiotics can support different symptoms, so you need to choose probiotic strains that have been shown to colonise in the vaginal tract such as Lactobacilli crispatus, Lactobacillus paracasei F-19®, Lactobacillus rhamnosus GR-1® or Lactobacillus reuteri RC-14®. If you pick a product that contains these strains, you can be confident that they are reaching the right area.   

If vaginal atrophy is a concern, there are products available to help.

Firstly, if you are eligible (post-menopausal, over 50 and do not currently have a vaginal infection), you can buy over-the-counter pessaries called ‘Gina’ at your local pharmacy.

‘Gina’ contains E2 (estradiol) oestrogen and has been shown to help with dryness, soreness, burning, itching and painful intercourse. If you are not eligible, you will still need a prescription from your doctor.

Secondly, you can try hormonal topical lubricants such as natural vaginal moisturisers, feminine intimate oils and water-based lubricants.

Recent studies also show that sea buckthorn oil, a berry from the Himalayas can offer support for menopausal vaginal dryness, burning and sensation. You can purchase sea buckthorn oil as a food supplement.  

Many of us have experienced intimate health issues at some point in our lives, and know that when your vagina, vulva and bladder aren’t feeling right it has a whole-body impact, sometimes making it difficult to continue doing the things you love.

So, our advice is - please don’t suffer in silence if you are struggling with pelvic health issues, there are a variety of self-help options available depending on your personal preferences.

But, if things aren’t feeling quite right and you have concerns about your pelvic health, then we recommend having a chat with your GP or a specialist pelvic physiotherapist.


Why do lactobacilli dominate the human vaginal microbiota?

Association of Vaginal Microbiota With Signs and Symptoms of the Genitourinary Syndrome of Menopause Across Reproductive Stages

Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article

Probiotic Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 exhibit strong antifungal effects against vulvovaginal candidiasis-causing Candida glabrata isolates

Efficacy of Lactobacillus Rhamnosus GR-1 and of Lactobacillus Reuteri RC-14 in the treatment and prevention of vaginoses and bacterial vaginitis relapses

Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study

Written by Claire Foss, nutritional therapist
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