Are You at Risk of Premature Menopause?

Some women suffer the menopause before the age of 40, putting them in the category of women going through a premature menopause. The same symptoms which are attributed to a natural menopause still occur, such as emotional problems, hot flushes, vaginal dryness and a lower sex drive. However, for some women going through this early in life, the symptoms can be even more severe. Studies also suggest that women who have a premature menopause also seem to get weaker bones faster than those going through this at a later stage in life. This increases the risk of osteoporosis and bone damage. There are a number of reasons why women go through premature menopause, from genetic causes to unexpected results from surgery. Defects in the woman’s chromosomes could be a cause, such as in women with Turner’s syndrome who are born without a second X chromosome. This causes the ovaries to not develop properly, leading to menopause earlier than expected. Likewise, women who have a family history of early menopause are more likely to experience it early themselves.

 

Researchers have found that autoimmune diseases can also trigger this process – the body’s own immune system mistakes part of the reproductive system to be a threat and attacks it, damaging the ovaries and preventing them from producing female hormones. In women who have had surgery to remove the ovaries, known as a bilateral oophorectomy, menopause occurs straight away. This means she will no longer have periods and her hormone production will decrease at a rapid rate. She may also experience menopausal symptoms immediately too, such as hot flushes and a lowered sexual desire. Chemotherapy can also cause ovarian damage, leading to a premature menopause. It’s common for women who are undergoing chemotherapy to stop having periods, suffer fertility issues and even lose their fertility. It may take a few months or it sometimes happens straight away. This cause of early menopause depends on the type of chemotherapy you have, the age you are when you have it, and how long the treatment lasts for though, so you will need to discuss this with your GP. The younger you are when you undergo the chemo, the less likely you are to go through the menopause early.

 

If you think you’re suffering from premature menopause, your GP will probably ask you if you’ve noticed any changes that are commonly associated with menopause, such as vaginal dryness, irregular periods and problems sleeping. Menopause is usually only diagnosed when a woman hasn’t had a period for over twelve months. There are cases where these normal signs won’t be relevant with premature menopause diagnoses, though. This means you may have to have a blood test which measures the follicle-stimulating hormone (FSH) which can determine if you’re going through a premature menopause. Your ovaries use this hormone to produce oestrogen, so when they stop making this your FSH levels rise. If your levels of this hormone are higher than normal, it’s likely that you’ll be diagnosed with premature menopause. There are many resources available to offer advice on this topic, as well as your GP being your first port of call for any questions you may have. Women going through the menopause can take hormone replacement therapies to combat the effects of a lowered hormone production, as well as ways to resolve issues with your sex drive. Speak to your GP if you would like to discuss medication and treatments to help you through this stage.

Categories: Causes, early menopause, hormone production, hot flushes, Menopause, Premature, premature menopause, Sex Drive, vaginal dryness, Women

What To Expect AFTER You’re Expecting: Vaginal Changes

It’s natural for your vagina to change after giving birth, but these changes can be a real dampener to your sense of sexual health, on top of the other things affecting your wellbeing once you become a mother. Still, you can deal with these post-pregnancy vaginal changes as long as you know what to expect and how you can help speed your recovery.

 

1. Wider vagina: According to Dr Suzy Elneil, consultant in urogynaecology at University College Hospital, London, ‘The vagina can feel looser, softer and more “open,” as well as looking and feeling bruised or swollen. This is nothing to worry about, as the swelling and openness should start to reduce a few days after your baby is born. The chances are that your vagina won’t completely return to its pre-birth shape, but Dr Elneil says, ‘We always recommend pelvic floor exercises.’ Also known as kegels, pelvic floor exercises help to tone your vaginal and pelvic floor muscles, and this prevents incontinence, firms your vagina and improves sexual satisfaction.

 

2. Vaginal dryness: When you were pregnant, you had higher levels of oestrogen in your body but now that they’re gone your vagina feels dryer than usual. However, this vaginal dryness should improve with time. Dr Elneil explains, ‘Once you stop breastfeeding and your periods have returned, the levels of oestrogen revert to pre-pregnancy levels.’ If this dryness is causing problems in your sex life, it’s important to talk to your partner about it so you don’t have to worry alone. You may need to start using a water-based lubricant (oil-based ones can tear or rip latex condoms) to make sex more comfortable until the dryness subsides.

 

3. Soreness and stitches in the perineum: Dr Elneil notes, ‘The vaginal area can feel painful or sore in the immediate period after childbirth. This usually improves within 6–12 weeks after the birth. We always recommend pelvic floor exercises to help make the situation better in this case, too.’ It’s common for the perineum to feel sore after giving birth, especially if your skin tore or you needed stitches to repair a tear or episiotomy. Although over-the-counter painkillers can help, you should consult your midwife, GP or pharmacist first if you’re breastfeeding. Keeping the perineal area clean is important, which means you need to change your sanitary pads as soon as you need to, wash your hands before and after you change them and have a bath or shower every day to keep your perineum clean. If you have a lot of pain or discomfort or you notice a smell in your perineal area, talk to your health visitor or GP.

 

4. Pain during sex: Having sex again after you’ve had a baby is a decision that’s different for everyone, as there’s no right or wrong time to start. However, you should refrain from rushing into it, no matter how much you won’t to, as painful sex won’t be pleasurable – and where’s the fun in that? Again, lubricants may be able to help if your vagina feels dry, but if the pain during sex is caused by discomfort around your perineum, it might be worth visiting your health visitor or GP, as these medical professionals can look and check that it’s healing in the right way. Giving birth, looking after a baby and feeling tired from those experiences can make you feel less like having sex these days, which it totally normal. However, instead of avoiding sex, talk to your partner so you both know what the situation is, and you can deal with it together. If you do start having sex again, don’t neglect contraception as you may end up getting pregnant three weeks after giving birth, and surely you want a bit more of a break than that!

Categories: dr elneil, floor exercises, giving birth, health visitor, Pain During Sex, pelvic floor, perineal area, recommend pelvic, vagina feels, Vaginal Changes, vaginal dryness

Could Your Sex Problems be a Sign of Other Health Issues?

There are many sexual health problems that can affect your wellbeing, but so often we sweep them under the rug. Research scientist Debby Herbenick, author of Because It Feels Good: A Woman’s Guide to Sexual Pleasure and Satisfaction, explains, ‘Sex and health do reflect each other, but because sex is still often seen as taboo, as something we don’t talk openly about, people often separate the two in their lives.’ So let’s take a look at you sexual wellness, and what these problems are telling you.

 

1. You’re avoiding sex because it hurts.

According to a 2010 survey by Indiana University’s Centre for Sexual Health Promotion, 30% of women had experienced mild to moderate pain during their most recent sexual encounter. Herbenick notes, ‘That’s a striking number – we didn’t expect it would be that big.’ This pain may be because of insufficient foreplay or the penis striking your cervix, but if it’s a more general pain, like burning, stinging or even knife-like, this could be vulvodynia (pain syndrome). Six million women are affected by this syndrome, and the causes are unknown, but a vulvovaginal specialist can help you find the right treatment.

 

2. You have trouble climaxing.

If you take forever to climax, if at all, you might have diabetes. This disease can damage your nerves – including the ones your brain uses to send unconscious signals for involuntary responses, such as sexual stimulation – and small blood vessels, which restricts blood flood to your sexual organs. Whether you’ve been diagnosed with diabetes or not, go to your doctor and mention all your worrying symptoms, as he or she can help your glucose control (which can improve you responsiveness) or refer you to a gynaecologist.

 

3. You’re not menopausal, but you still don’t lubricate much when aroused.

Vaginal dryness is a common side effect just before menopause and afterwards, due to shifting hormones, but if you’ve been affected by dryness before the age of 45, your heart health may be to blame. Herbenick notes, ‘Lubrication comes from hormones but also from fluid in your bloodstream. If there’s impaired blood flow for any reason, it could reflect early signs of a cardiovascular issue.’ If you have other signs of heart trouble – such as fatigue, shortness of breath and heartburn – go for a check-up. While you’re there, ask about other causes of vaginal dryness, like early menopause, perimenopause and medication side effects. You can also buy vaginal lubricants over the counter in the meantime.

 

4. You’re never in the mood for sex.

If sex is hardly ever on the menu, you might be short on testosterone. This hormone is linked to desire in both men and women, and your levels decline dramatically in the years between you 20s and 40s. Elizabeth G. Stewart, a vulvovaginal specialist in Boston and co-author of The V Book, advises supplemental testosterone if the problem is mainly hormonal, but tread carefully, as the long-term consequences of testosterone-replacement therapies aren’t yet well studied. Stress, fatigue, boredom, and relationship woes can all contribute to your low sex drive, so working on those other factors can also help.

 

5. Urine leaks out when you have sex.

You might wet yourself a little when you orgasm, but this isn’t just part of the excitement run amok. Herbenick urges, ‘Peeing at any point during sex, whether foreplay, intercourse, or climax, is not normal.’ Leaking during sex is a form of stress incontinence, which is the most common form of incontinence in women. However, there are many ways to prevent this from happening. Avoid liquids for the hours leading up to sex and experiment with different positions; rear or side entry, for example, take pressure off your bladder and urethra. You can also consult a urologist who specialises in incontinence, as he or she will be able to provide pelvic floor exercises, medications, or even a surgical fix.

Categories: Advice, health, herbenick, herbenick notes, nbsp, Pain, Sex problems, sexual, sexual health, underlying issues, vaginal dryness, vulvovaginal specialist

What Makes a Healthy Vagina and How Do You Maintain One?

In the quest for better wellness, the vagina often gets overlooked. However, Dr Suzy Elneil, consultant in urogynaecology at University College Hospital, London, and spokesperson for Wellbeing of Women, says, ‘Generally, good vaginal health is maintained by making sure you’re in good general health. This includes healthy diet and exercise. Normal exercise helps maintain good vaginal function, as walking and running helps the pelvic floor to tone up and helps ensure good general health.’

 

Still what about when you’ve got a lot of discharge, bacteria or a bad odour coming from your vagina? According to Dr Elneil, ‘Vaginal discharge is not always a bad sign. There is a myth that copious clear or white discharge is associated with sexually transmitted infections. Changes in the amount of discharge can be 100% hormonal – in other words, linked to the menstrual cycle, pregnancy or menopause.’ Professor Ronnie Lamont, spokesperson for the Royal College of Obstetricians and Gynaecologists (RCOG), adds, ‘The vagina contains more bacteria than anywhere else in the body after the bowel, but the bacteria are there for a reason.’ If the balance of bacteria is disturbed, this can lead to infection and inflammation. So, how do take care of your vaginal wellness?

 

1. Washing your vagina: Perfumed soaps, gels and antiseptics can affect the healthy balance of bacteria and pH levels in your vagina and cause irritation, so these are best avoided. You’re better off gently washing the area around your vagina (the vulva) with unperfumed, plain soap every day. Professor Lamont notes, ‘All women are different. Some may wash with perfumed soap and not notice any problems. But if a woman has vulva irritation or symptoms, then one of the first things you can do is to use non-allergenic, plain soaps to see if that helps.’ Dr Elneil adds, ‘During your period, washing more than once a day may be helpful,’ and it’s also essential to keep the area between the vagina and anus clean, ‘by washing that area at least once a day using your normal bathing routines.’

 

2. Douches: Some women use a douche to “clean” the inside of the vagina, as it flushes water up into the area and clears out vaginal secretions. However, the inside of your vagina is self-cleaning, and using a douche can disrupt your normal vaginal bacteria. Professor Lamont explains, ‘I can’t think of any circumstances where douches are helpful, because all they do is wash out everything that’s in the vagina, including all the healthy bacteria.’ Although you may think that douching protects your wellbeing against STIs or vaginal infections, it may in fact increase your risk.

 

3. Scented wipes and vaginal deodorants: Again, these products can disrupt your vagina’s natural, healthy balance. Professor Lamont comments, ‘If nature had intended the vagina to smell like roses or lavender, it would have made the vagina smell like roses or lavender. Dr Elneil points out that it’s normal for your vagina to have a natural scent, noting, ‘Vaginal odour can change at different times of the reproductive cycle and shouldn’t always be thought of as being a sign of infection or illness.’ However, sometimes if the vaginal smell is very unpleasant it may indicate a sexual health problem, especially if you also have unusual vaginal discharge. These two symptoms together are caused by bacterial vaginosis, which is easily treated with antibiotics. You should consult your GP if you’re concerned.

 

4. Safer sex: During sex, some bacteria and viruses can get into the vagina, including the bugs that cause sexually transmitted infections (STIs). Unless you use a condom every time you have sex, you’re exposing yourself to chlamydia, gonorrhoea, genital herpes, genital warts, syphilis and HIV.

 

5. Cervical screening: If you’re aged between 25 and 64, it’s important to have regular cervical screenings. This makes it easier to catch any abnormal changes in your cervix early on, which may make all the difference to your wellbeing. The earlier abnormalities are identified, the earlier they can be treated to stop cancer developing. Talk to your GP to find out more about cervical screening.

Categories: cervical screening, dr elneil, professor lamont, sexually transmitted, transmitted infections, vagina health, vaginal dryness