But first, a disclaimer!

As the title suggests, I am writing this as I would a diary. This is purely my experience of Perimenopause as I am experiencing it and no more, no less. I will add useful information where relevant (I promise to keep it as simple as I can), however this is not to be misinterpreted as any form of medical advice, but as I am a practicing Naturopath, I will add were applicable some natural alternatives that have worked for me. Take it or leave it.

I hope instead that whoever reads this, if anyone, finds a common denominator or at least the realisation that you are not alone! And, that we need to talk more about this!!

Hands up if you have a dry vagina?

So, lets jump in and not beat around the bush (no pun intended, ish). I am 46 years old and for about a year or so I have started to feel a few things changing, both physically and emotionally. The first being my dry vagina. I mean even just writing those words makes me sigh wtf! For me it was a slow progress as in, it didn’t just suddenly change overnight but, the realisation came during and shortly after intercourse.

Initially it was just a feeling of discomfort, no pain just a feeling of ‘uh oh’ – I’m aroused but I have nothing to show for it down there….shit! Now, it didn’t go from moist to dry just like that, rather it would come and go which made me think that I was being paranoid until one night my hubby said ‘ouch’ because it was as uncomfortable for him as it was for me. In the moment there was nothing else to be said except to use a lubricant (more on that in a minute) but it played on my mind for days afterwards. It didn’t even occur to me (seeing as I specialise in women’s health -right!?) that I was entering perimenopause as I hadn’t had anything else feel off. And most conversations are around menopause itself and not the run-up towards it and so it made me realise that I need to get things down in black and white and hopefully, if anyone else reads this, get women in their 40’s talking about this. This way we can talk about looking after ourselves and our cycles a long way before menopause hits us!

So a little background….. vaginal dryness can be a symptom of low oestrogen and excess progesterone, as is vaginal atrophy (thinning & inflammation of the vaginal wall), dry skin, tender breasts, mood changes and lack of concentration, hot flashes and night sweats and brittle bones or the beginnings of osteoporosis. But more on these in later posts. For now I am going to stick to the dry vagina. For women, oestrogen and progesterone are two of our main sex hormones responsible for many functions in our bodies. Oestrogen is vital for maintaining bone and muscle health, enhancing cognitive and cardiovascular health, regulating the menstrual cycle and lubricating the vagina. Progesterone helps to prepare the endometrial lining of the uterus for implantation of a fertilised egg. When this does not happen then it prepares for the shedding of this lining i.e. menstruation. Therefore as we get closer to menopause our oestrogen and progesterone levels start to change resulting in the possible dreaded dryness.

Now I don’t know about you (assuming someone is reading this) but I truly believe prevention is better than cure especially when it comes to hormones. As a Naturopath, I know that our bodies are constantly wanting to heal ourselves and when I started experiencing the dryness, I decided to take steps to help and support my body through these changes so that my journey through menopause is as smooth as it possibly can be.

Firstly I wanted to address the symptom directly as this was the pressing problem. As a Herbalist I have been prescribing Calendula (marigold) oil as a wonderful first aid remedy for cuts, minor burns and abrasions, sunburn, nappy rash etc, but it has also been used as a vaginal douche for infections or inflammation. Needless to say it works like a charm. Unlike shop-bought lubricants, pure Calendula oil is exactly that, pure with no additives to make it smell or taste of strawberry (?) And the great thing is, you don’t have to just use it before sex but whenever and as often as you like , it is that safe and gentle yet effective. Some of my clients also rave about coconut oil which I have honestly not tried yet as I haven’t needed to but it might be too oily or feel to greasy for some whereas Calendula oil is absorbed well and does not have a sticky texture. For those that prefer coconut oil, make sure it is organic, virgin and cold pressed to ensure the best quality, or at least the best you can afford.

And another thing – THONGS! Why are women wearing underwear that cuts them in 2 and sticks to us? It is said that thongs can irritate the clitoris (and stick to it) , can relocate bacteria from the anus to the vagina (Ouch) as well as cause chaffing (agreed). Now there is no concrete evidence to support this but I have experienced all of the above. I personally do not find thongs comfortable (am I alone here?) But besides that, it is also important to look at the materials that we use close to our skin, especially near a part of our bodies that needs to breath and not feel squashed under polyester. But for me personally it is about comfort, as much as I love lingerie, I love even more the feeling of slipping into pure cotton panties and knowing that my bacteria is exactly where it needs to be thanks. Ok so rant over for this article.

Now for the prevention bit….. this is a hard one because every woman goes through hormonal changes differently. While one might suffer terribly from night sweats for example, others might suffer with mood swings, memory loss or unexplained weight gain and so what seems to be working for me might not work for you. And although I cater for the individual needs of patients, this diary is about my personal experience and what has worked for me and my patients. So here are some pointers that have worked for me, in the hope that I can slow things down a little to improve my vag and bring balance to my hormones. Oh! and it seems to be working , woohoo!

Firstly, my beloved herbs. One of my favourites is the ancient Shatavari (Wild Asparagus) which has been used for centuries in Ayurvedic traditions as one of the most rejuvenative herbs for women. It is an excellent tonic, promoting longevity & increasing strength and resilience as well as balancing hormones!

Next is Calendula or the magnificent Marigold flower. Other than being one of the best first aid remedy for minor burns, cuts or abrasions, it is wonderful for a host of skin issues such as acne, eczema, sunburn, nappy rash, athletes foot to name a few. It is also wonderfully oestrogenic which means it is able to increase the production/availability of oestrogen in our bodies.

Another favourite of mine and one which is hugely underused in my opinion is the wonderful sage. There is wonderful folklore surrounding this powerhouse (why should a man die if there is sage in his garden?) and rightfully so. It is another oestrogenic much like Calendula, but it also helps with the emotional side of imbalanced hormones as it is a nervine and carminative and so is very helpful in promoting brain function and reducing fatigue & nervous depletion.

Alongside herbs, it would be helpful to supplement with the following:

Boron is a mineral that helps body absorb oestrogen (and testosterone)

B-complex – a good quality B-complex is vital to women’s health (has to be in methylated form for improved absorption). B-vitamins help the body to create and use oestrogen

Vitamin D – essential in countless bodily functions and a vitamin that most people in the UK are deficient in. It is essential in the production of hormones such as oestrogen but also general hormonal balancing and detoxification.

Collagen – has received huge amounts of press recently and rightfully so. It is essential for skin health (especially elasticity and hydration), heart, gut and brain health. It provides essential building blocks for the production and optimal function of sex hormones as well as vital in the prevention of bone loss.

Omega 3 – the anti-inflammatory omega! This is another building block for the production and optimal function of our sex hormones as well as general lubrication of our tissues.

Foods to consider including in your diet are:

Nuts (especially almonds, brazil nuts and cashews which are high in oestrogen) which are nutrient rich and a source of protein

Avocados, a healthy fat high in folic acid which helps to lower blood pressure and improving blood circulation

Pumpkin seeds, a superfood in their own right. High in zinc and unsaturated fatty acids, boost our immunity as well antioxidant and anti-inflammatory

Dark chocolate (hallelujah!!!) – rich in magnesium, oestrogenic and antioxidant rich. With dark chocolate is important to but 75% and higher due to the higher quality of the above minerals

Broccoli and spinach are said to be both beneficial for hormonal balancing with Broccoli slightly ahead with assisting in oestrogen absorption and detoxification.

Eggs contain oestrogen and are nutrient rich, but always try to buy the best you can afford, i.e. free range and organic

So there you have it, a few things for you consider and take away and hopefully some, if not all of the listed items can help with your dry vagina! However, I cannot stress enough that nothing makes up for a balanced eating plan and lifestyle and what I have listed above is certainly not exhaustive, but instead are the highlights for me! As I said before, every woman goes through their cycle differently and with differing intensity, and so I advise working with someone who can help steer you to a new balance! And of course I am here if you have any questions

Next up, I will be writing about hot flashes…… sigh!