The down-low on down there

Here's how to support your vaginal health through midlife and beyond, from strengthening your pelvic floor to enhancing pleasure.

- WORDS by ASHLEIGH AUSTEN

If you've ever found yourself googling “is this normal?” about anything below the belt, you're not alone. As we age, so too do our vulvas and vaginas – and yet, for something that plays such a vital role in our wellbeing, pleasure and quality of life, it's still shrouded in a bit of mystery.

“Vaginas aren’t just about sex – though that’s definitely a key part of the picture,” says Dr Ceri Cashell, a GP specialising in women's health and co-founder of the free online menopause community, Healthy Hormones. “They're also essential to our everyday comfort and health.”

Whether you're navigating dryness, itching, bladder leaks or changes in desire, now's the time to get curious and proactive about what's happening.

Ask your GP about vaginal hormones

As hormone levels drop during perimenopause and menopause, vaginal tissues can become thinner, drier and more prone to irritation. This condition is known as genitourinary syndrome of menopause (GSM). It affects around half of postmenopausal women.

“GSM is the new name for vaginal atrophy or ‘senile vagina’, and it refers to all the symptoms caused by hormone deficiency in the vulvovaginal and bladder tissues: Dryness, itch, pain, discomfort, urgency, frequency, incontinence, prolapse, recurrent urinary tract infections (UTIs), loss of arousal, and painful intercourse,” says Dr Cashell.

Topical (or vaginal or local) hormone therapy, either oestrogen or DHEA which converts to oestrogen and testosterone, can be a game changer. It comes in the form of creams, pessaries or vaginal tablets and delivers oestrogen directly to the vaginal area to restore moisture, elasticity and comfort. It has UNSPLASH. THE ADVICE IN THIS ARTICLE IS GENERAL IN NATURE AND DOES NOT TAKE INDIVIDUAL CIRCUMSTANCES INTO ACCOUNT.