Something to talk about
When women think about health, issues such as weight control, arthritis, and diabetes often come to mind. But vaginal health has an important role to play in your daily comfort and your ability to enjoy intimacy.
Many things have an impact on vaginal health, including age and hormone levels. So do soaps and other body products you may use, and the regularity of your sexual activity.
As you approach menopause, it's important to have regular medical evaluations of your vaginal health — even if you feel fine, but especially if something feels "wrong."
The more you understand, the better prepared you can be to ask the right questions. So find out about the role of estrogen throughout your life, the phases of menopausal transition, and what might be causing pain or discomfort during intercourse.
Estrogen: always changing, always important
Estradiol is an estrogen hormone produced in a woman’s ovaries. Hormones act as chemical messengers — they move through the bloodstream and control the actions of cells and organs in other parts of the body.
For women, estrogen helps regulate the menstrual cycle and stimulates breast development. For decades, it regulates the ebb and flow of menstrual cycles and plays a critical role during pregnancy. Over time, it is vital to bone health.
Inside the vagina, estrogen helps maintain blood flow. This keeps the vaginal walls flexible and elastic and promotes production of natural lubricants. Estrogen also helps maintain the chemical balance in the vagina and surrounding tissues so that healthy bacteria grow and flourish. This helps prevent frequent vaginal infections. The tissues of the urinary tract also require estrogen to stay healthy, strong, and infection-free.
When estrogen levels begin dropping as menopause approaches, this brings about yet another cycle of change in a woman's life.
Cycles of change
To a large extent, estrogen is responsible for the continual cycles of change that you experience throughout your life.
The amount of estrogen in your body is always changing — within your monthly cycles when you are still menstruating and over the course of your life.
Estrogen causes especially important changes:
- At puberty: through childhood, the estrogen lining of the vagina remains thin, but once the estrogen lining thickens as a result of estrogen stimulation, the menstrual cycle begins.
- During pregnancy: estrogen, along with progesterone, is produced in the placenta, and helps maintain a healthy pregnancy.
- In the different phases of the menopausal transition: declining levels of estrogen change the nature of menstrual cycles and can cause uncomfortable symptoms throughout the body (such as hot flashes) and in the vagina and surrounding tissues.
The phases of the menopausal transition
- Perimenopause is a time of transition that starts with the years leading up to menopause and ends one year after menopause. "Peri-" means "near or around." Perimenopause marks the onset of menstrual cycle changes and other menopause-related symptoms. Estrogen levels during perimenopause are irregular and generally on the decline. Approximately 90% of women go through about 4 to 8 years of menstrual changes before menopause actually occurs.
- Menopause occurs when you stop having periods altogether for 12 straight months. Your ovaries produce minimal levels of estrogen.
- Postmenopause is the span of time after menopause and begins 1 year after your last period. Uncomfortable vaginal symptoms that stem from the loss of estrogen can continue or even worsen, unlike hot flashes, which usually subside over time.
The transition, or perimenopause, usually begins in the mid-to-late 40s, and the average age at menopause is 51. However, every woman has her own experience of menopause. Therefore, you should discuss any symptoms you may be experiencing with your health care professional to determine together what you are experiencing, what to expect and the best way to manage your vaginal health.
Remember, your health care professional is the main source of information about you and your health. Please consult your health care professional if you have any questions about your health or your medications.