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Vaginal atrophy and vaginal dryness often go together as the drop in oestrogen at the menopause is causing not only the dryness but also the thinning of the tissue.

Vaginal dryness can affect women of all ages, but it is particularly common in women during menopause, affecting half of all women at this stage in  their life. It is perhaps the most distressing and least talked about symptom of the menopause.

Vaginal dryness can make your vagina feel dry, itchy and at times tender.  It may take you longer to become lubricated during lovemaking, which can make sexual intercourse feel uncomfortable, or even painful. And not only can vaginal dryness cause pain and bleeding during intercourse, it can also increase the possibility of developing a vaginal infection, which itself compounds the problem.

Normally, mucus membranes (the vaginal epithelium) located at the mouth of uterus keep the vagina moist. Oestrogen helps these membranes to produce lubrication and stay plump and soft. The lubricant is slightly acidic, which helps to protect the vagina from foreign bacteria, keeping it free from infection. Low levels of oestrogen also cause the vagina and surrounding connective tissue to lose elasticity and the tissue that lines the vagina to become thinner and more fragile.

Although hormone imbalance is the most probable cause of vaginal dryness, stress and fatigue play a part, too. More rarely, a condition known as Sjogren’s syndrome (an autoimmune condition which causes dryness throughout the body e.g. eyes, vagina, skin etc.), cancer treatment medications and chronic yeast infection.

THE NATURAL APPROACH

Using your diet to help with vaginal atrophy and vaginal dryness

Women who eat a nutritious diet generally experience fewer problems with their vagina in the menopausal years, so do follow my guidelines for a healthy, balanced diet. For hormone balance it is especially important to make sure you eat enough essential fatty acids or EFAs and to supplement with fish oil. A low- or no-fat diet can make your whole body drier including the vagina. It’s also important to stock up on phytoestrogens, as research shows that foods rich in phytoestrogens, such as soya, chickpeas, lentils, flaxseeds and so on, can change the cells of the vagina so that they become more soft, elastic and moist – all essential for pain-free intercourse.

Eating plain organic yogurt with live culture four to five times a week may also help to maintain healthy intestinal flora and vaginal balance.

Supplements

Omega-3 fish oils (including 700mg EPA and 500mg DHA, daily) Essential fats are a necessary part of hormone balance and they can help to keep the body lubricated including the vagina (the one I use in the clinic is NHP’s Omega 3 Support)

Vitamin C (500mg twice daily) This nutrient is essential for healthy collagen formation and collagen gives tissue elasticity.

Vitamin E (400iu daily) This powerful antioxidant is known for its anti-ageing properties and research has shown that it can help with vaginal dryness.

Probiotics (daily, taken one containing at least 22 billion bacteria) Probiotics help keep unhealthy bacteria and yeasts (flora), such as candida, in check, reducing your susceptibility to vaginal infections.

Drink water
Check you are drinking enough water. We should all consume 6 to 8 glasses of water or herbal tea, a day. This keeps your tissues (vagina as well as skin etc.) hydrated and plumped up, without water tissue dries up and can crack.

Get moving
Regular exercise can help keep your vagina supple and lubricated. Aim for at least 30 minutes moderate exercise five to six times a week. In addition, practise Kegel exercises (see page 00) regularly, as these can help strengthen your pelvic muscles making sex more enjoyable.

Have more sex
Regular sex and masturbation can help because women who have sex once or twice a week tend to lubricate more rapidly when aroused. Spend longer on foreplay, too, as it can help you to lubricate. You may find it helpful to use a good-quality, natural lubricant before sex, too. I like to recommend Yes an organic lubricant that contains no preservatives or chemicals and is made from cocoa and shea butter.  (Available from www.naturalhealthpractice.com)

Take care of your vagina
Avoid douches, talcum powder, hot baths, perfumed toilet papers and bath oils and foams as they can irritate the vagina. Don’t wash the inside of your vagina with soap as this will dry out the skin. The vagina is self-cleansing and in most cases warm water is all that you need to wash it.

Avoid tampons
If you are menstruating wear pads and avoid using tampons as these can dry out the vagina. If you want to wear a tampon, buy organic cotton ones and make sure you change it every three to four hours. Avoid wearing panty liners between periods unless absolutely necessary as these can dry and irritate the vagina.

Communicate with your partner Insufficient lubrication can be connected to feelings about your partner and your relationship.  If you have repressed anger or resentment towards your partner you may have trouble getting aroused and sufficiently lubricated. Deal with problems as they come along, instead of letting them accumulate and try to talk about how you feel, rather than apportioning blame or guilt. Use plenty of “I” statement.