Vaginal dryness or any ‘down there' issues are not something we tend (or want) to talk about.
Yet it's one of the most common symptoms of menopause, and most of us will experience it at one time or another.
And not only can it have a huge impact on our lives, it can be excruciatingly painful.
Jane Lewis suffered so badly from it that she decided to write a book. ‘Me and My Menopausal Vagina‘ has been a huge hit! Not surprisingly she found out that many other women were also suffering in silence.
I caught up with her to find out her story. Watch the video below or listen to the full interview on my podcast;
Jane, tell us about why you wrote this ground-breaking book?
“I suffer from vaginal dryness, which sounds as if it's nothing really. But it took me to the point of being almost suicidal. Pills had to be hidden away and I needed counselling. I realized that there's lots of books out there on the market, but there was nothing solely about vaginal dryness, which is actually officially called ‘genitourinary syndrome of menopause' or ‘GSM'.
I have three daughters and a granddaughter and I wanted the taboo of taboos to be broken. And I think two years on, there is definitely conversations around this subject and women are definitely starting to talk.
More and more women are talking and talking about their vaginal problems and the medical profession, many of whom have read my book and realising that they are missing these issues. And they are starting to change the way they talk to and treat women.”
So what happened to you? What kind of symptoms did you have and how did it affect your life?
“I'm 54 now, and when this all really started, I was 45. So there's a huge myth that vaginal dryness is only for post-menopausal women. I had the very common symptom that many women talk about, painful sex to start off with. It affects the whole genital area, inside the vagina, the external area of the vulva and the urinary area, which is the bladder and the urethra. I was getting constant UTI's. I'd never had UTI's in my life. I was getting up to go to the toilet, two, three, four times at night, sometimes every hour on the hour. Externally, my vulva was burning, itching, sore, splitting.
Not everyone has the external pain. So lots of women just have pain when they have sex. They can still wear their skinny jeans and they look fine. But actually when you start asking questions, oh yes, I go to the toilet a lot. Yes I keep going to the doctor for UTI's. “
And did you go to the doctor about it? Obviously you were in a lot of pain.
“Yes I went to the doctor and because I was 45, they couldn't accept, at the beginning, that it was to do with being menopausal. So I did do a bit of what's called ‘doctor shopping' because believe me, when you can't sit down, you can't wear trousers, you can't wear jeans, I had to stop riding my horse. You want to get help. But I eventually found someone who realized that this was hormones.”
Now tell us a little bit about self examining and when did you start doing that?
“My oldest child now is 34 years. I had three children in four years and I looked at myself after I'd had my last child, and vowed never to look again because quite honestly, it looked like a car crash.
But once I was getting very, very sore, I had a look one day and all I remember thinking was, I don't know what it looked like but it definitely did not look like this. It was quite a shock because it was raw, raw red. The episiotomy scars were on the verge of splitting.
It's really important that we do examine ourselves, every month as routine. There are a huge amount of skin conditions out there. And we all assume thrush. Everyone thinks every itch leads to thrush. Actually, there are lots of skin conditions of the vulva, that have very similar symptoms to thrush, including vulva cancer and lichen sclerosis. And so it's very important we don't self treat.”
And what are we looking for, redness?
“You are looking for redness. You are looking for whiteness, you are looking for sores, darkness, moles, and basically it's getting to know your normal. So if after a month, anything is there that you're not happy with, you need to get the doctor to have a look.”
What is the role of oestrogen in vaginal dryness?
“As oestrogen basically declines, we can become itchy, something called formication on the skin externally, you think you've got ants. Your skin becomes dry, and exactly the same is happening in the vagina, in the bladder, in the urethra and the outer skin externally. But and also very common, is an itchy back passage. “
What are the options for women when they find themselves suffering from these kind of issues?
“You can get the vaginal moisturizers, which go internally in the vagina. There are some better than others but ultimately the vagina, bladder and vulva love oestrogen. And I'm not pushing oestrogen on people because there are those that are very scared of it. And we all know that a lot of that is miss press. But use it locally in the vagina. The amount in it is very, very, very small. And there are those that have had oestrogen receptive breast cancer, who can and do use localized oestrogen. And then there's roughly 20 to 25% of us who need HRT as well.”
Can you just explain the types of localized treatment?
“There's actually eight different products we can get within the UK, on prescription. The most commonly used, is something called Vagifem, which is a tiny little pessary that goes into the vagina and releases a small amount of estradiol. There are two types of pessaries. We have Vagifem and we have something called IMVAGGIS. We then have two types of cream. We have Ovestin and we have Oestriol. These are a type of estrogen called oestriol. We then have a pessary ring (Estring) which sits in the vagina for 90 days and releases the equivalent of, just over five doses of Vagifem per week.
So there is quite a lot of choice. And quite often, you know, the first one may not work or you may need a combination. Some ladies need a combination of an oestradiol and oestriol.”
Thank you so much for speaking out about this very, very difficult issue for many women.
I would urge you if you have any of the symptoms Jane has mentioned, to firstly buy her book, so that you understand what you need to talk to the doctor about.
And secondly, go join her Facebook group and ask advice and questions in there.
Contact us if you'd like to get your hormones properly tested.