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Hot flash news flash – the time for shame has past

March, 2010

Your significant other has just taken a little blue pill and is looking at you the way he hasn’t since before your children were born. But if you’re one of the more than 50 per cent of post-menopausal women who suffer from vaginal atrophy, the butterflies in your belly might not be excitement.

If you’re in that awkward spot, you might feel like it’s too late. But it’s not, and ignoring the problem won’t make it go away. Symptoms of vaginal dryness don’t disappear on their own and, untreated, they will probably get worse.

Symptoms range from the seemingly benign – itching or mild burning – to such severe headaches as incontinence, frequent urinary tract infections and painful intercourse.

“It’s like sandpaper, rubbing over and over,” said one woman, cringing. A woman might also experience light bleeding after sex, a clear, watery discharge or urgency with urination.

“Women need to understand that vaginal atrophy is not a disease,” Shawna Johnston of the ob-gyn and urology department at Queen’s University in Kingston says on the website TheBigOw.ca. “It’s a natural state.”

As women enter menopause, their estrogen levels drop, which can lead to moodiness, night sweats, hot flashes and vaginal dryness.

"Though arousal increases blood flow and can help restore your natural fluids, you might need to take it slow in the bedroom and that’s okay".

Here’s the difference, according to Michèle Moreau, a general practitioner who specializes in menopause: Women speak about their hot flashes, but no one talks about this. With the lack of estrogen, women lose the wrinkles in the vagina. The tissue becomes rigid and thin and bleeds more easily. Even if a woman isn’t sexually active, she might notice some discomfort.

Moreau suggests some doctors might not be fully educated on the issue of vaginal atrophy or perhaps, during the course of a hurried examination, women forget to ask the question. They might not be comfortable bringing it up or it’s possible that the doctor, faced daily with life-threatening illnesses, might underestimate the impact this painful condition can have on a woman’s wellbeing.

Menopause is considered to start 12 months after the end of a woman’s last period, around age 51. The Mayo Clinic notes that in addition to physical changes, women can have feelings of loss as their fertile days are clearly behind them. But one’s life, sexual and otherwise, is far from over.

Estrogen is vital for the normal reproductive development of girls and it regulates the menstrual cycle. It also helps protect women against heart disease, Moreau notes. There are many treatments available for the proactive woman, but they must buck up their courage to talk to a doctor. The first step is over-the-counter, water-based lubricants.

“And there is always saliva,” Moreau says. “Remember that it’s completely free and always readily available.”

This is a restoration project, Moreau says. There are various levels of hormone-replacement therapies. Women, under the care of their doctors, can try topical creams, suppositories, patches or a ring that is inserted into the vagina and will release hormones for up to three months. Adding a hormone cocktail concerns women who have read conflicting studies on the effectiveness and safety of estrogen treatments. These treatments must be prescribed, so the conversation with your doctor should address all your worries.

“There are options that are helpful, that are easy” and mess-free Moreau emphasizes.

Moreau puts some of the responsibility not on the woman’s doctor, but on her partner’s doctor.

“When they prescribe for erectile dysfunction, they should make sure the woman has a vagina that is supple enough to support it,” she says.

Don’t just talk to your doctor – talk to your partner. Though arousal increases blood flow and can help restore your natural fluids, you might need to take it slow in the bedroom and that’s okay. It’s a marathon, not an Olympic-calibre sprint.

Dr. Michèle Moreau will hold a three-hour conference May 27 at Notre Dame Hospital, 1560 Sherbrooke St. E., from 7pm to 10pm. The conference in French, but many of the slides presented will be in English. Call to register: 514-890-8000, ext 25416.

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