Having satisfying sex is an important part of life, no matter how old you are. In fact, South Africa's Sexual Rights Charter states that you have the right to have sex just for the pleasure of it, and to enjoy it right into old age.
However, this may be difficult when women are confronted with issues like vaginal atrophy — the thinning, drying and inflammation of the vaginal walls due to the body producing less oestrogen. Falling oestrogen levels cause women to produce less vaginal lubrication, which can make sex uncomfortable and even reduce the likelihood of orgasm.
Results of a recent Closer survey clarifying vaginal atrophy's impact on sex and relationships show that any woman can be affected by this condition, although it is very common after menopause.
As a result, many women avoid sex because of the vaginal discomfort, finding it less satisfying or too painful, while some report loss of libido.
The respondents said vaginal discomfort had a negative impact on their feelings and self-esteem, with half of them believing they had lost their youth, or being upset that their bodies did not work as they did before.A third reported no longer feeling sexually attractive, and a quarter felt they were "less of a woman".
Worryingly, despite the negative impact of vaginal dryness, it was left untreated in 40 percent of women, even though treatment is available. Notably, almost half the women surveyed in the study said too little information was available about the symptoms and treatment of vaginal discomfort.
There's help
Healthcare experts recommend vaginal hormone therapy. Although only 21 percent of the women surveyed had relied on the therapy, most of those who had said it had a positive impact on their sexual relationships, and that their partners also recognised the benefits.
"Oestrogen therapy may be local or systemic, but local is preferred when symptoms of menopause are limited to the vaginal area," says Dr Trudy Smith, a Johannesburg-based gynaecological oncologist and obstetrician. "Local oestrogen therapy is administered directly into the vagina, and can be given as either vaginal tablets, cream or a ring."
"Women need to be encouraged to ask for assistance and not be embarrassed"
– Dr Carol Thomas
"Vaginal oestrogen is safe, effective and easy to use," says Dr Carol Thomas, gynaecologist and president of the South African Menopause Society. "The changes that happen in the body as a result of menopause are normal, and there is no need to suffer in silence. Women need to be encouraged to ask for assistance and not be embarrassed."
The study authors encourage more open discussion about vaginal atrophy, and that women talk to their healthcare providers to discuss treatment options. It is also crucial to talk to your partner about it, and to counter any embarrassment with the knowledge that you're not the only woman in the world going through this.