I write headlines like this to amuse myself (I have the sense of humor of a 13-year-old boy), but in reality there’s not much of an oral history of vaginas. People don’t talk about their vaginas—or the issues that accompany said vaginas—nearly enough. So where can we turn for the answers to our most pressing vag-related questions (nope, there is no way to get though that sentence without it sounding like innuendo)?
Dr. Carolyn DeLucia, that’s where. She’s an M.D., FACOG—Fellow of the American Congress of Obstetricians and Gynecologists, a women’s intimate health expert with practices in New York City and New Jersey. The vast majority of her practice is women our age. “Many women will begin to notice differences following the birth of their first child,” says DeLucia, “but the biggest shifts are when a woman enters menopause. Losing our friend estrogen changes things.”
“Most of the changes of menopause—the mood swings, hot flashes, night sweats—all minimize as we go on through life,” says Dr. DeLucia. “The changes that happen to the vaginal tissues are the only changes of menopause that get worse over time, unless addressed.” So let’s address them! These are the four most common reasons that women in the stages of menopause find themselves in Dr. Lucia’s office, and what can be done about them.
Vaginal Dryness and Irritation
The decrease in estrogen that happens during menopause leads to dry skin…everywhere. “Every single woman will notice some change in their lubrication,” says DeLucia. With less estrogen, there’s less blood supply to your vagina, causing the tissue to become thinner and more susceptible to irritation.
Every single woman will notice some change in lubrication.
What we can do:
“I really like VagiVital,” says DeLucia, referring to VagiVital AktivGel, a hormone-free, water-based gel that restores pH balance and treats symptoms of vaginal atrophy. “It’s a lovely, at-home treatment that’s a very comfortable way of moisturizing the tissue,” says DeLucia. “You can even use VagiVital preventatively so you never get the point of experiencing pain.”
Another cause of irritation: Our bodies’ shifting pH. “The vagina becomes more acidic, throwing off our bacterial flora and leading to bacterial vaginosis, which gives you a burning sensation,” explains DeLucia. She recommends VagiVital Moisturizing V Cleanser, which combines a hydrating gel and Nordic botanical oil to restore the pH balance. (You can find both products at us.vagivital.com and on Amazon.)
As estrogen wanes, the lack of blood flow to the vagina means that there’s less supportive collagen and elastin in the tissue, meaning “we lose our ability to lubricate, stretch, and accommodate,” says DeLucia. “For some women, vaginal penetration can feel like you’re being ripped in half. And once inside the vagina, a penis can feel like a prickly, round hairbrush.”
Once inside the vagina, a penis can feel like a prickly, round hairbrush.
What we can do:
You need to restore blood flow in order to regenerate the collagen and elastin in the tissue. DeLucia often turns to the FemiLift from Alma, the first laser of its kind to come to market. It uses CO2 energy and is “the exact same laser that’s used to build collagen in the face, with a modified handpiece for the vagina. It’s the gold standard in terms of regeneration, but it’s a little bit more invasive than some of the other procedures and it has a three-day downtime when you can’t have penetration,” says DeLucia. The treatment is done once a month and it takes three months to complete the full treatment, then once a year to maintain.
DeLucia also uses a brand new device called EmFemme 360 from BTL, which uses radio frequency to delivery collagen- and elastin-stimulating energy in just eight minutes. For the more modest among us, DeLucia likes the Alma Duo, which uses shockwave therapy to externally delivery energy that enhances blood flow, lubrication, plus varying degrees of improved clitoral stimulation and orgasmic function. Speaking of which…
Difficulty Achieving Orgasm
The flip side to painful sex is a loss of sensation, explains DeLucia. It’s “another side effect of decreased blood flow to the vaginal area.”
What you can do:
In addition to the blood flow-promoting technologies above, DeLucia uses her secret weapon: The “O” Shot. “Platelet rich plasma, or PRP, is the elixir of life,” she says. “It’s the portion of our blood that helps us heal ourselves.” It’s typically injected where isn’t much blood supply, like the inside of a joint, to heal in that particular location. “So when injected directly… and I know this sounds horrifying…but directly into the clitoris and directly into the front wall of the vagina, we stimulate sensation,” explains DeLucia. “Of course the area is numbed before the procedure with topical anesthetic first, then a local clitoral block, and ice so it’s typically painless. The results are unbelievable.” O-yes!
Lack of Libido
It’s not shocker that if you’re experiencing dryness and painful intercourse that you probably crave sex less often. “Desire decreases in women pretty drastically in the 40s and into the rest of our lives,” says DeLucia. “Patients tell me, ‘I don’t even think about sex anymore.’ And that doesn’t have to happen.”
Testosterone is responsible for libido and for sensation in the clitoral area.
What you can do:
Being horny has a lot to do with hormones. And while a lack of estrogen is responsible for many of the issues we deal with, it’s a lack of testosterone that affects our sex drive. “Testosterone is responsible for libido and for sensation in the clitoral area,” says DeLucia. With very detailed bloodwork, we can do bioidentical hormonal replacement therapy to tweak your hormones and improve vaginal function.” Other things DeLucia credits testosterone with? Improved mood, more energy, less brain fog, increased mental acuity and focus, ability to burn fat and build muscle, and improved quality of sleep. Sign me up!
This article is sponsored by VagiVital.