According to the North American Menopause Society, menopause begins one year after the final menstrual period. Perimenopause is the timeframe before menopause, anywhere between 5 and 10 years before the final menstrual period, which is where signs of menopause start to begin.
Genitourinary Syndrome of Menopause
One of the major changes seen in menopause is a condition called genitourinary syndrome of menopause. This is where the lower urinary tract and vulvovaginal tissues change secondary to the loss of testosterone and estrogen from the failing ovaries. This change in hormones causes less lubrication and thinning of the tissues, leading to vulvovaginal dryness and irritation.
The Impact on Everyday Life and Intimacy
These changes can make everyday activities and intimacy uncomfortable. First-line therapies include vulvovaginal lubricants and moisturizers. There are a variety of over-the-counter lubricants available however it is important to know which ones are the most body safe to use. Lubricants do not contain any hormones and can be used daily or on an as needed basis.
Choosing the Right Lubricant
Water-based lubricants tend to need to be applied more frequently secondary to dry tissues absorbing the product into the tissues versus staying at the surface level to decrease friction. On the other hand, silicone lubricants tend to last longer without the need for re-application throughout the day or throughout sexual play. Remember, lubricants should contain no parabens, glycerin, or fragrances. These can all irritate the vulvovaginal tissues leading to the breakdown of those structures and increased discomfort and/or pain.
How do you use a lubricant?
Applying anywhere there is irritation or dryness is the way to go. There is no improper placement of a lubricant and you cannot use them too often. Regular use has been shown to improve genital sensations and even increase pleasure during sexual activities. Do not apply a lubricant directly to the genitals. Instead apply to your fingertips, rub your fingertips together to warm up the liquid and then apply all over the skin and even into the creases of the vulva and the vaginal opening. If you need assistance internally, use a syringe filled with your choice lubricant. Apply the lubricant to the vulva first with fingertips, then while lying down, gently insert the tip of the syringe into the vaginal opening, no more than a centimeter in, and slowly push the lubricant internally. It may take a few times to know how much lubricant you need each time. Some of the lubricant will leak out, but most do not stain your clothing and can be rubbed externally at that time.
When to Consider Additional Treatments
While a lubricant at the beginning of menopause may be all that you need, as menopause progresses, you may find yourself needing more than just the lubricant and/or a moisturizer. Sometimes a topical local hormone treatment may be needed. Talk to your healthcare provider about your options. And don’t forget that you can still use a lubricant in combination with other genitourinary syndrome of menopause therapies.
Grab some lube today - what’s stopping you?
References:
Menopause: The Journal of The North American Menopause Society Vol. 27, No. 9, pp. 976-992 DOI: 10.1097/GME.0000000000001609 2020 by The North American Menopause Society
