Pelvic Floor: Kim Vopni
As we approach and move beyond menopause our hormone levels fluctuate. And eventually, decline to a point where we notice significant changes in our bodies.
“They can be bothersome but they are not something you need to live with.”
Many of those changes occur in our vagina and pelvis. These symptoms fall under the term genitourinary syndrome of menopause or GSM. Like many of the symptoms of menopause, they can be bothersome but they are not something you need to live with.
What Is Genitourinary Syndrome Of Menopause?
GSM is the new term for vulvovaginal atrophy. And is considered a collection of symptoms that affect the labia, the clitoris, the introitus, the vagina, the urethra and the bladder. These symptoms result from the lack of estrogen that occurs at and beyond menopause.
What Are The Symptoms Of Genitourinary Syndrome Of Menopause?
There are many symptoms associated with GSM. These include: itching, burning, painful sex, bleeding, more frequent UTI’s, incontinence, bladder urgency and frequency, loss of labial fullness, contraction of the clitoral hood, narrowing and shortening of the vagina, prolapse, laxity in the pelvic floor muscles, loss of vaginal rugae, increased pH, more prominent urethra, and decreased sensation.
None of this sounds welcomed and unfortunately many women suffer in silence not knowing that help exists.
How Common Is Genitourinary Syndrome Of Menopause?
Studies have found that 50% of women aged 50-60 report symptoms. In women older than 70 the rate increases to 72%. In the Women’s Health Initiative Study, 60% of the participants presented with vaginal atrophy. Another study showed that 82% of women had experienced vaginal discomfort for one year or more.
“Studies have found that 50% of women aged 50-60 report symptoms.”
The majority of the women in these studies did not associate their symptoms with the loss of estrogen. And the majority did not seek treatment. Most women do not know that help exists or are too embarrassed to discuss their symptoms with their care provider.
How Is Genitourinary Syndrome Of Menopause Diagnosed?
There is no specific test for GSM. Doctors will often look at blood markers of LH and FSH to determine if someone is post menopause but symptoms are the most important. In addition, a physical exam to look at the tissues will also be helpful. Questions about sexual intercourse, pleasure, and incontinence will be strong indicators as well.
How Is Genitourinary Syndrome Of Menopause Treated?
What is generally considered as the gold standard for treating GSM is local vaginal estrogen meaning estrogen that is placed in the vagina and around the clitoris, urethra and vulva. Estrogen immediately brings up fear of cancer and cardiovascular risks which stems from the Women’s Health Initiative Study.
Moreover, this is a challenge that many professionals are working to overcome and educate women on the benefits and safety of vaginal estrogen. There are no links to cancers of any kind or cardiovascular risks with the use of vaginal estrogen and it is argued that all women as they approach menopause should begin using it and continue using it for the rest of their lives.
“many professionals are working to overcome and educate women on the benefits and safety of vaginal estrogen”
Therefore, vaginal moisturizers made with hyaluronic acid can also be extremely helpful in increasing the capacity of the tissues to retain moisture while also healing already dry irritated tissue. You can use a vaginal moisturizer and vaginal estrogen but typically not on the same day. Moisturizers and vaginal estrogen are most often inserted at night right before sleep.
Pelvic floor exercise can help improve blood flow and circulation and can help reduce symptoms from incontinence and prolapse. Along with the loss of estrogen is the loss of collagen and elastin and muscle.
While there is no evidence to show that collagen supplementation is helpful, there is also no evidence to show that it is not helpful. Considering the researched benefits of collagen supplementation on the skin and that the vagina and pelvis have the same types of collagen as our skin does, we can infer that there could be benefit to supplementing. Exercise and collagen will not, however, influence the amount of estrogen in the tissues.
Vaginal dhea cream such as Julva and intrarosa are also great options.
When it comes to sex, with or without a partner, using a lubricant is essential. Finding one that does not interfere with the vaginal pH is key and use a water-based option if you are using toys of any kind.
Above all, help exits. Do not suffer in silence. Speak to your family doctor, gynecologist or naturopathic doctor about estrogen. Vaginal moisturizers and lubricants can all be purchased online with no prescription.
Please note: This is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition.
About the Author:
Kim Vopni is a self professed pelvic health evangelist and is known as The Vagina Coach. She has a BA in Psychology and a postgraduate certificate in Health and Fitness. She is a certified fitness professional who became passionate about spreading information on pelvic health when she was pregnant with her first child.
Kim is the founder of Pelvienne Wellness Inc – a company offering pelvic health programs products and coaching for women in pregnancy, motherhood and menopause. She is also the creator of the Ab System – a revolutionary birth prep and recovery system for pregnant women. Kim certifies other fitness and movement professionals to work with women with core and pelvic floor challenges through her Core Confidence Specialist Certification and Pre/Postnatal Fitness Specialist Certification. You can find her on-line at www.vaginacoach.com and on social media @vaginacoach