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  • Carla Evans

Hormonal changes creating discomfort down there?

Hi everyone,

This email is mostly for the ladies but it affects men too because it changes the way women experience sex (amongst other things) - so if you want to support the women in your life, read on wonderful men!

A common complaint of women during perimenopause and menopause is vaginal dryness and it's related problems. I'm going to refer to Lara Briden's book, The Hormone Repair Manual as she is much more of an expert in this field than me and explains it all really well. I highly recommend her books!

"Low oestrogen can cause thinning of the tissues of the vaginal, vulva and urethra. It's called vaginal atrophy or the genitourinary syndrome of menopause (GSM), and is one of the few permanent rather than temporary, symptoms of menopause. Symptoms include dryness, pain, itching, increased urinary frequency, incontinence, prolapse and increased susceptibility to urinary tract infections."

- The Hormone Repair Manual, Lara Briden

Other symptoms can include painful sex or bleeding during/after sex, painful urination, stress incontinence (urinating when you cough or run etc) and change in libido or ability to orgasm.

It's more common from menopause onwards (menopause is defined as the stage when there has been no period for 12 months) but clinic experience shows it in women at most stages of perimenopause.

It is worth seeing your GP or specialist about GSM as vaginal oestrogen can help with the majority of symptoms. The main downside of vaginal oestrogen is it may trigger vaginal thrush but it is not a commonly reported side effect.

Aside from this, there are many ways to help manage GSM. Here are Lara's top tips:

  • Zinc supplement 30mg per day to improve the integrity of the vaginal tissue. I recommend zinc glycinate, citrate or picolinate.

  • Sea buckthorn oil 3 grams per day to improve the integrity of the vaginal tissue.

  • D-mannose 2 grams per day to prevent UTIs if they are E. coli dominant.

  • Vaginal lubricants and moisturisers - I recommend Olive and Bee and Lara recommends Yes and Replens.

  • Vaginal probiotics - the two strains Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14 have good evidence to show improvement in bacterial vaginosis and recurrent UTIs. BioMedica Femex Forte and Blackmores Women's Flora Balance contain these two strains. Bear in mind the Blackmores one (available retail) is half the strength of the BioMedica one (practitioner only). These can be taken orally and vaginally - talk with your practitioner about which might be best for you.

  • Pelvic floor physiotherapy for preventing and treating prolapses.

There can be other reasons for severe itchiness around the vulva and vagina so if the above actions don't help please investigate further with your practitioner.

All in all, vaginal, vulva and urethral discomfort are very common during this hormonal change, you are not alone. There are many steps you can take to alleviate the symptoms so don't just put up with it, speak to your GP and natural health practitioners to find the right solutions for you.

Happy hormone adapting!

Carla :)

P.S. Want to re-read a previous email but have deleted it? (accidentally of course!) Not to fear - all previous emails are available on the website blog or facebook.

P.P.S. Online bookings are available for current clients.



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