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    Use it or lose it!

Dear Ate Anna,

I am in my early fifties. I have been a widow for five years. Now, there is a man in my life and we are seriously thinking of getting married. I am worried that my body “down there” is not ready for this as I have had a pretty “dormant” sex life these past few years. I have read that a woman has to “use it, or lose it.” Is that true? Ate Anna, I would really appreciate some suggestions to help me with this.

Clara

Dear Clara,

There is truth to this common saying, “use it or lose it.” In fact, it applies to many parts of the body such as muscles, the brain and the genitals. If you want strong muscles, you need to use them or else they will become weak, soft, and flabby. If you want to reduce your chances of getting Alzheimer’s disease, experts say that you need to keep your brain active by reading, writing, playing Sudoku or other mentally challenging games. Likewise, if you want to keep your genitals in good shape, regular sexual activity can definitely help. Sexual activity can improve blood flow to the vagina and keep the vaginal tissues healthy.

Clara, you mentioned that you are in your fifties. At this stage of your life you may notice some changes in your body – hot flashes, irregular periods, mood swings, fuzzy thinking, insomnia or pain in your joints.

Some women also experience discomfort in their genitals and urinary system – dryness in the vagina, itching or a burning sensation in the vagina, light bleeding after sex, painful intercourse, urinary tract infections, urgency to urinate, or urinary incontinence (leaking). The medical term for this condition is “vaginal atrophy.” Ate Anna prefers to talk about these symptoms as vaginal changes.

For women of your age, vaginal changes are usually caused by a decrease in the female hormone, estrogen. A woman’s ovaries gradually produce less estrogen in the years leading up to menopause. Estrogen plays an important role in keeping vaginal tissues lubricated and healthy. When the estrogen levels are low, the vaginal tissue loses some of its elasticity and can become thinner and drier. The vaginal canal becomes shorter and tightens. This can cause discomfort or painful intercourse.

Some women first notice these vaginal changes during perimenopause (the years leading up to menopause) while others will not notice symptoms until several years after menopause. However, unlike hot flashes and other menopausal symptoms, which are temporary, vaginal changes will not go away on their own. Thinning of the vaginal tissues can continue during the rest of a woman’s life. Dryness and irritation in the vagina may also increase her chances of getting vaginal infections and urinary tract infections.

Clara, Ate Anna believes that the thought of having intercourse may not seem “enjoyable” to you after reading this far. Don’t get stressed out! There are a few things that you can do to prepare your body after not having had sex for quite some time.

It is important for you and your partner not to rush during sex. Allow time for you to become aroused during intercourse to encourage vaginal lubrication. In other words, more time for foreplay before intercourse. To increase comfort during sex, you can use a water-based lubricant such as KY Jelly or Astroglide. Do not use petroleum jelly – it may irritate your vagina and cause an infection. Also, if you are using a condom, petroleum jelly can break down the latex in the condom.

You can also try using a vaginal moisturizer on a regular basis such as Replens, or K-Y Silk-E. These moisturizers may help relieve vaginal dryness and restore some of the moisture in your vagina. You can get these moisturizers over the counter in any drug store.

Clara, it is also important to know that some prescription and common over-the-counter drugs, like antihistamines, can dry vaginal tissue (as well as nose and eye tissues). Douches, sprays and perfumed toilet paper and soaps can irritate vaginal and genital tissues. Drinking more liquids also helps keep the whole body, including the vagina, hydrated.

However, if none of these remedies is helping to reduce vaginal discomfort during sex, do not suffer in silence. It is important for you to see a doctor to do some tests and check for other underlying health problems. The doctor may also discuss with you some other treatments that can help relieve the vaginal dryness or irritation that is often associated with menopause and aging.

Clara, not all menopausal women have discomfort during sex. One of the best methods of prevention is to follow the “use it or lose it” principle, either with or without a partner. It also helps to have information about the health issues during this stage of life. There is a new edition of the book Our Bodies, Our Selves that covers a lot of information about women’s sexual and reproductive health, including a section on menopause and aging. You can buy it at any bookstore or even borrow it from the public library. A good medical website to refer to is: www.mayoclinic.com/health/vaginal-atrophy

Take care,
Ate Anna

Ate Anna welcomes your questions and comments. Please write to Ate Anna, Suite 200 – 226 Osborne Street N., Winnipeg, MB, R3C 1V4 or e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

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