Taking Control of Menopause: How to improve genitourinary syndrome of menopause

By Tiffaney Marlow, Reg. PT

Menopause is a unique experience for every woman with the average age of onset being 51 in North America. Some women experience very few symptoms throughout menopause while others find it debilitating. Symptoms may start as early as pre-menopause and may last for a few years. Menopause is caused by a decrease in ovarian function and a decline in the production of sex hormones, estrogen, progesterone and testosterone. Changes in hormone levels has a global effect on your body, influencing muscles, bones, the vasomotor system and even your urogenital system. We often associate menopause with symptoms such as hot flashes, altered sleeping patterns or changes in mood, but did you know it can effect the tissues of the vulva and vagina as well? If you are undergoing menopause and are experiencing vaginal dryness, painful intercourse and urinary urgency or frequency you may have genitourinary syndrome of menopause.

Previously, this group of syndromes was called vulvovaginal atrophy, but was recently changed to genitourinary syndrome of menopause to more completely describe the symptoms. As women undergo menopause, the decline in estrogen can cause thinning of their vaginal tissue and weakening of the muscles of the pelvic floor, which are important in supporting the organs of the pelvis and maintaining continence. These changes can also lead to urinary urgency, frequency, incontinence and can be associated with recurrent urinary tract infections. Up to 50% of women who have undergone menopause will experience vaginal dryness and the associated itchiness, burning, and possible painful intercourse. Misconceptions about women and their sexuality at an older age can inhibit discussion about these changes, but it is important to speak up! Your family physician and a trained pelvic floor physiotherapist can help to reduce these symptoms and improve your pelvic health and sexual health!

To improve vaginal dryness there are a variety of vaginal estrogen available in creams and tablets that can be prescribed to you by your family physician. Natural oils such as coconut oil and vitamin E can also be useful in maintaining the tissue health of your vulva. It is important to be sure to use lubrication during intercourse, and it has been shown that regular orgasms (two times per week) can help to improve blood flow to the vulva and vagina which is also important in maintaining tissue health. Your pelvic floor physiotherapist can teach you a series of exercises for the muscle of the pelvic floor, improve blood flow to the vaginal tissues and help you control your urinary urgency and frequency.

Come speak to one of our trained pelvic floor physiotherapists today to find out what you can do to improve your pelvic health.

Dr Potman, M Gass (214) Genitourinary syndrome of menopause: new terminology for vulvovaginal atrophy from the International Society for the study of Women’s sexual Health and the North America menopause Society. The journal of the North American Menopause Society. 21(10)

E. Palmer (2015) Menopause and Exercise. Clinical Review Cinahl Information Systems, a division of EBSCO Information Servic

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