Vulvovaginal troubles are common after menopause and are linked to pelvic floor organ prolapse. These troubles impact women’s lifestyle, emotions, and sex life, and were found to worsen with pelvic-related issues. Unfortunately, many women are not receiving help for their condition, according to the research published in the journal Menopause.
The researchers recruited 358 women over the age of 55 who answered questions related to the symptoms experienced after menopause and the impact of these symptoms on their lives.
Common vulvovaginal symptoms included itchiness, burning, dryness, and discharge. A little bit over half of the women experienced these symptoms, which were found to have a significant impact on their lives. Forty percent of the women said the symptoms took a toll on their emotional health and 33 percent said they impacted their overall lifestyle. Over three-quarters of the women who were sexually active noted that these symptoms posed a problem to their sex lives.
Along with these symptoms, women also reported urinary frequency or leakage as a result of urgency, along with pelvic floor organ prolapse. They also experienced greater menopause-related symptoms, such as hot flashes.
Despite living with these symptoms, nearly one-third of the women never saw a gynecologist in the last two years. Plus, a whopping 83 percent were not receiving treatment, like a low-dose estrogen or vaginal creams.
JoAnn V. Pinkerton, executive director of the North American Menopause Society, explained, “This study demonstrates that there is an unmet need for postmenopausal women to have regular gynecologic visits where questions can be asked about vaginal and urinary health problems, and assessment can be made to determine the presence of vulvovaginal atrophy, urinary symptoms of urgency or incontinence, or pelvic floor disorders, and offer FDA-approved safe and effective therapies.”
“Diagnosis of these problems requires a pelvic exam and evaluation of the vaginal and vulvar tissues to look for atrophy, prolapse, or infection. Safe and effective therapies are available, and include, not only the first-line, low-dose vaginal estrogen creams, tablets, or rings, but also ospemiphene, the new oral selective estrogen receptor modulator, or SERM, that treats painful intercourse,” noted Dr. Pinkerton.
Urogenital and bladder problems after menopause
Menopause can affect a woman’s urinary system in numerous ways, from increasing the risk of urinary tract infections to pelvic organ prolapse. Menopause can contribute to vaginal atrophy, which causes vaginal dryness, soreness, and painful sex. Due to decreasing estrogen levels, the elasticity weakens and the vagina becomes thin, resulting in damage and vaginal atrophy symptoms.
A prolapsed bladder can be categorized into one of the following grades: mild, moderate, severe, and complete. In a mild grade, only a small portion of the bladder falls into the vagina. In moderate, the bladder drops enough to be felt at the opening of the vagina. In severe, the bladder begins to protrude through the vaginal opening, and in complete, the entire bladder protrudes out of the vagina. This last stage is often associated with other forms of organ prolapse.
The most common cause of bladder prolapse is aging. The muscles that support the bladder become weaker over time, especially when women enter menopause. This is associated with a reduced production of estrogen, which is responsible for keeping the muscles strong.
Childbirth can cause bladder prolapse with stress to the vaginal tissues and supporting muscles.
Straining caused by heavy lifting, bowel movements, or long-term coughing or constipation can also weaken the muscles, thus contributing to a prolapsed bladder.
A reduction in the levels of estrogen is the primary reason why post-menopausal women have an increased susceptibility to UTIs. This is because urinary tract infections develop when unhealthy bacteria such as E. coli grow in the bladder. Normally, the healthy bacteria – lactobacilli – prevent urinary health problems by stopping the growth of these unhealthy bacteria, and estrogen encourages a robust level of lactobacilli. However, estrogen levels drop after menopause, which can also mean a drop in lactobacilli and, consequently, an increased susceptibility to bacterial bladder problems such as UTIs.
As you can see, the changes that occur through menopause can have a variety of consequences to a woman’s urinary and vaginal health. The good news is, many of these issues can be resolved with a simple visit to your doctor. Unfortunately, many women do not seek out medical advice, leaving their health issues untreated, which further aggravates the problem. By being open with your doctor, you can tackle these issues and, in turn, improve your quality of life.
Related: How long does menopause last?