During perimenopause (several years before the end of menstruation), the level of estrogen, hormones that, among other things, are responsible for proper lubrication of the vagina, drops sharply. The epithelium that covers the inside becomes thinner, less flexible and more prone to injury and infection, especially since pH also increases due to a lack of glucose, which is necessary for lactic acid bacteria. The vagina itself becomes shorter and narrower. In addition, tension in the perineal tissues is reduced, which can lead to stress urinary incontinence and, in extreme cases, vaginal prolapse. Thinning of the labia is also observed. Hormonal changes lead to a decrease in the sensitivity of erogenous zones (nipples, perineal region) to irritants. All of this can lead to a decrease in sex drive and even to fear of intercourse. So what to do
How can we help ourselves?
According to many experts, the best way to achieve satisfactory intercourse is to maintain sexual activity. Stimulation increases blood flow to the pelvic tissues, while improving blood flow helps maintain elasticity. Endorphins (“hormones of happiness”) released during intercourse have a strong analgesic effect and improve mood.
Therefore – even if we feel ailments – instead of giving up sexual intercourse, we should choose such forms that give the greatest pleasure, and at the same time do not load, for example, the joints or the spine. If you are worried about vaginal dryness, you should use so-called lubricants – topical creams before having sex.
The daily diet should be rich in vitamins. It also doesn’t hurt to look for foods rich in L-arginine (soybeans, nuts, sesame seeds, gelatin, spinach, seafood, turkey), calcium, iron, and zinc. Alternatively, you can use ginseng or ginkgo.
What does medicine offer?
If the main problem is insufficient lubrication of the vagina, the doctor may prescribe vaginal medications that deliver estrogen directly to the epithelial cells, restoring their structure, increasing their thickness and elasticity. For many women, this has the advantage that when applied topically, much lower doses of estrogen are effective than with traditional hormone replacement therapy (HRT), which consists in filling the “missing” hormones with pills. Hence, there is no increased risk of, for example, breast cancer.
In turn, testosterone patches or creams not only increase libido and relieve hot flashes or vaginal dryness, but also increase energy to act and protect against osteoporosis.
Beware of drugs!
Medications for high blood pressure, depression, and ulcers can reduce the desire for sex and the satisfaction of sex. Oral drugs for allergies and colds dry not only the nasal mucosa, but also … the vagina.
Medications taken for endocrine reasons can further lower estrogen levels, which reduces blood flow through and hydration of the perineal tissue. Smoking has a similar effect.
