When we reach our late 50s, we often believe we have a good grasp of what to expect during menopause. Hot flashes, mood swings, and changes in our sleep pattern become familiar companions. But then, something unexpected sneaks into our lives, something rarely discussed in public discourse: vulvovaginal atrophy.
You might wonder why there's a new term for it – "genitourinary syndrome of menopause" (GSM). Well, it turns out that the old term had negative connotations, and the medical community needed a more publicly acceptable way to describe the condition. After all, words matter, and "atrophy" and "vagina" aren't exactly dinner table conversation.
GSM encompasses changes to the vulva, vagina, and bladder that occur due to hormonal shifts during menopause. Vaginal dryness, burning, itching, irritation, pain during sex, and even post-coital bleeding become part of daily life. Urinary symptoms like recurrent infections and incontinence can also make an appearance. For some women, these symptoms remain mild or even unnoticed, but for others, they can be debilitating.
A survey of thousands of women with GSM revealed that these symptoms not only affect physical health but also have a significant impact on quality of life. Many reported decreased enjoyment of sexual activity and an adverse effect on their overall well-being.
What's particularly frustrating is that unlike some menopausal symptoms that tend to improve with time, GSM symptoms often worsen. Yet, many women hesitate to seek medical help, even though there are safe and simple treatments available.
For mild to moderate vaginal dryness, the first-line treatment is using lubricants and moisturizers. Lubricants reduce friction during sex, while moisturizers provide day-to-day comfort by mimicking natural vaginal secretions. There are various options on the market, but one study found that the most expensive vaginal moisturizer was no more effective than a much cheaper alternative.
Now, you might be wondering about safety. The World Health Organization recommends that personal lubricants and vaginal moisturizers should not exceed a certain level of osmolality, which measures the concentration of dissolved components. How did they determine this level? They used slugs! Yes, slug mucosal irritation (SMI) tests involved covering slugs with lubricant over several days to see how much irritation and tissue damage occurred.
The results were eye-opening. Some commonly used lubricants caused significant irritation and tissue damage, while others met the safety criteria. The only two vaginal moisturizers that passed the test were the Yes brand aloe vera gel-based moisturizer and the Balance Activ brand hyaluronic acid-based one. As for lubricants, Yes, Good Clean Love, System Jo, and one product by Durex – their Sensilube gel – made the cut.
Recommended lubricants and moisturizers based on their safety and effectiveness:
Vaginal Moisturizers:
- Balance Activ Brand Hyaluronic Acid-Based Moisturizer
Lubricants:
- Good Clean Love Lubricant
- System Jo Lubricant
- Durex Sensilube Gel
This discovery was a game-changer. Armed with this newfound knowledge, I tried a few of these products and finally found the relief I'd been seeking. It was liberating to regain that comfort and intimacy that I thought I had lost forever.
What struck me most was the importance of sharing this information with the women in my life. We need to break the silence and create a supportive community where we can openly discuss these issues. There's strength in knowing you're not alone and that there are solutions available.
So, here's to embracing conversations about our health, no matter how intimate they may seem, and to empowering ourselves with knowledge that can make a world of difference in our daily lives. We deserve comfort, confidence, and the freedom to enjoy all that life has to offer, no matter our age.