Painful sex during perimenopause
Low oestrogen affects your sexual health. Boom. It can cause sex to be painful if you’re prone to a dry and thining vaginal wall, and the likelihood is that as you near the end of your perimenopause, if you’re prone to recurrent urinary tract infections and thrush that just keeps coming back, painful sex because of a dry vagina might be an issue for you too.
No Queen can get by with a dry vagina.
For reasons I don’t really understand, this subject (along with lots of others on perimenopause) gets swept under the carpet. But it can be a very distressing problem to have that plays all sorts of havoc with your relationships and your self-esteem.
If you pluck up the courage to mention it to your GP, you may be offered an oestrogen pessary (perhaps Vagifem), but if you don’t want to take synthetic hormones that leaves you up the creek. (Sidenote: sometimes you need to take the medication to get things under control. No Queen can get by with a dry vagina). If you’re having a look for what you can do yourself, unfortunately there isn’t much help to be had on Dr Google outside of eating soy products and flaxseeds.
I don’t find this particularly useful, because some of the science around eating phytoestrogens and lignans is a little sketchy.
Phytoestrogens and lignans may not be the answer
Some studies say that foods high in phytoestrogens (soy-based foods such as soy milk, tempeh and tofu, edamame beans) and lignans (flaxseeds, sunflower and sesame seeds, rye, oats and barley, among many other foods) will help with lowered oestrogen production, and other studies say that eating these foods don’t materially change your hormone levels.
There is lots of contradictory science out there, however what I believe to be true is that if you are eating a whole foods-style diet high in plant products, including legumes, nuts and seeds, fruit and vegetables, that you are doing the best you can to help with your hormones.
Better hormonal balance is more helpful
Key to getting through this “dry” patch is shortening the gap between your oestrogen and progesterone by getting some help with balancing your hormones, eating a healthy leaning-towards-plants type diet, and managing the symptom: a dry vagina.
Declining oestrogen generally comes towards the end of perimenopause and is more likely associated with a quick drop in oestrogen.
But take heart, if this is something you’re suffering with, once your female hormones balance out again you will generally go back to a better situation with vaginal lubrication.
What sort of lubrication to use
In the meanwhile, find a good lubricant – I recommend the YES WB brand, you can get it in the clinic or online.
If you don’t go for that product, make sure whatever you get is water-based, and please do not use coconut oil or any other thing you think might work – coconut oil and most other “oils” will change the pH in your vagina.
Hello UTI or thrush.
So, painful sex is usually the result of low oestrogen causing your vagina to dry up. There is help available – you may need to use an oestrogen pessary, however, you can also try a more natural alternative such as a vaginal moisturiser, and look for practitioners who can help you bring your hormones into a bit more balance.
And, before you start eating your weight in soy products and flaxseeds, remember that there is conflicting evidence around the ability of food to raise your oestrogen levels. None-the-less it is important to be eating a healthy leaning-towards-plants based diet.
Your dry vagina won’t last forever, but you do need to manage it for now.