The physical signs of menopause begin years before your final menstrual period. Changes can start as early as your 30s or 40s. The transition between the beginning of these signs and your final period is known as "perimenopause" and it is set into motion by changing levels of the hormones estrogen and progesterone. Hot flashes and night sweats are some of the first signs.
Some women begin to experience symptoms of vaginal dryness, which is a signal that falling estrogen levels have caused a condition called vaginal atrophy. As estrogen levels fall, the tissue lining the vagina becomes thinner and loses moisture and elasticity. You may feel itching or burning during urination, you may experience a slight discharge, and sexual intercourse and vaginal exams may cause discomfort or pain. Changes to natural protection mechanisms in this area make you more susceptible to bladder and vaginal infections.
The good news is that there are several treatments to relieve this discomfort, including tablets, rings and creams, which deliver a small amount of estrogen directly to the affected area.
There are helpful non-medicinal therapies you can try, too, such as water-based vaginal lubricants and moisturizers, which are available over the counter at any drug store. (Do not use petroleum jelly.) Other things that can help include special exercises known as Kegels, extended foreplay, and having intercourse regularly, which improves lubrication and blood flow to the genitals.
It may take time to find the right options - be patient. And remember, you needn't try to resolve this problem on your own! Your doctor can help you decide which treatment is right for you. Let her know what symptoms are bothering you, and what therapies you have already tried. (She may do an exam and tests to rule out any other health issues.) She will go over your medical history and she'll discuss the benefits and potential side effects of each therapy with you.
When talking about vaginal health, you may feel awkward and embarrassed at first, but keep in mind that open, honest communication will enable your doctor to understand your needs and make the best recommendations.
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