I recently attended a women’s sexual wellness class offered by a health care organization in my community. The presenter was a nurse midwife who specializes in women’s sexual health. She focused on sexual physiological changes and genital pain that women experience as they grow older. Most of this was related to menopause and vaginal atrophy.
I thought I’d share some of what I heard. Some of this I already knew, but some information was new to me. The statistics here come from studies of vulvo-vaginal discomfort and the effects on women*.
What I Learned
- Of the 25% of women who experience pain with intercourse, 72% have sex once a month anyway; 36% have sex at least once a week.
- Vaginal discomfort has a negative effect on women’s lives, affecting their sex life (65%), marriage/relationship (40%), self-esteem (26 %), and even their social life (13%). Some women experience so much vaginal and vulvar pain that they cannot even sit on a chair comfortably.
- Nearly 30% of women don’t tell their husbands or partners about their discomfort.
- Most women require clitoral stimulation to experience orgasm. I knew this already—but I was so glad the presenter said this because a lot of women aren’t aware that this is normal. I was sitting toward the front and heard quite a few sighs of relief behind me.
- The clitoris is far more expansive than what we can see. (I knew this already, too.) She showed us on a diagram just how much of our genital region had the clitoris behind it—basically, all of it. Every part of the genital region that feels good to have touched has part of the clitoris right behind it. (On the podcast, I referred to the clitoris as an “orgasm iceberg.”)
- Vulvar and vaginal atrophy turns plump pink genital tissue to a pale white, reduces the tissue (including the labia minora), and erases the inner accordion-like folds of the vagina.
- Birth control pills can cause vaginal atrophy at an early age—so women who are years away from menopause may still experience atrophy, discomfort, and pain.
- Frequent arousal helps counter vaginal atrophy, as it brings blood flow to the tissue in a way that helps maintain cellular health. The standard “use it or lose it” advice definitely applies here.
Pain during intercourse
- Having intercourse when you’re in pain is a bad idea because it creates a body memory of trauma that is difficult to counter in treatment. If you are experiencing pain with intercourse, seek help—because there are many avenues for treatment. Stop having intercourse (see item #1) and have “other-course” instead until the pain is successfully treated. Sexual intimacy is important, but oral and manual stimulation can work well. She also suggested placing a penile sleeve (affiliate link) between your thighs. Your husband can place his penis there instead of inside of you, and you’ll still have face-to-face intimacy. (She emphasized that the woman should get to have her orgasm first.)
Dealing with other symptoms of menopause
- Put a layer of Vaseline over the vulva before entering a chlorine pool to help prevent chapping.
- Use only water to wash the vulva. (The presenter suggested using a squirt bottle.) Unscented soap is okay for the anus, but the lady parts should not have soap at all.**
- You know AstroGlide, the personal lubricant? It was invented by NASA as a coolant for the space shuttle. I had no idea—but that is apparently the reason for its name.
- Exercise helps with hot flashes.
Have you attended any programs on sexual wellness or vaginal/vulvar changes? What have you learned? If you’ve experienced vulvar or vaginal atrophy, discomfort, or pain, what treatment have you found successful?
* Parish, S. (2013). Impact of vulvovaginal health on postmenopausal women: a review of surveys on symptoms of vulvovaginal atrophy. International Journal of Women’s Health, 5,, 437-447.
** If you have a medical condition that affects the vulva or vagina, consult your own doctor about the best way to maintain vaginal and vulvar health. For instance, you may find that a cleanser with a special pH balance works well for you.
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