THAT side-effect of menopause most woman have but no-one wants to talk about…

The first South African study to report on the impact of menopause on women’s sexuality finds that intimacy and good communication are closely linked, and that women must be encouraged to seek help.

Results show women and men are comfortable talking about vaginal discomfort but there is a need for women to talk to their health care professionals about this condition.


Having satisfying sex is an important part of life no matter how old you are. But all too often, age-related physical or emotional changes can lead to discomfort or disinterest in the bedroom. Falling postmenopausal oestrogen levels cause women to produce less vaginal lubrication, which can make sex uncomfortable and reduce the likelihood of orgasm.

A new study, the first of its kind in South Africa, focuses on postmenopausal vaginal atrophy. Results from the CLOSER (Clarifying vaginal atrophy’s impact On Sex and Relationships) survey – show that 50% of postmenopausal women are affected by vaginal dryness, and that it is crucial for doctors to initiate the discussion on the condition with their patients.

What’s more encouraging, and will hopefully increases awareness, is that 89 % of women were comfortable discussing vaginal discomfort with their doctors, and 58% felt comfortable to chat to their pharmacist.  A significantly higher proportion of black women than white was likely to consult pharmacies about their symptoms.

Vaginal discomfort is also openly discussed by couples. The study found that 80% of South African women told their partners when they first experienced discomfort, while most men interviewed said they had discussed the issue with their partners. A full 90% of men wanted their partners to engage them in these conversations.

These findings show that it’s vital for you to talk to your partner, and healthcare provider about vaginal dryness. Early detection and management are important for your long-term well-being. Don’t be afraid to ask questions about vaginal discomfort, and don’t feel embarrassed or alone – because you aren’t.


According to the study, many women avoid sex because of vaginal discomfort – they find it less satisfying or too painful, while some reported loss of libido. The women surveyed said vaginal discomfort had a negative impact on their feelings and self-esteem, with half of them believing they have 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% of women, even though treatment is available. This highlights the need for women to be educated about it, talk about it, and feel comfortable enough to ask their health care professional.



Although only 21% of the women surveyed used vaginal hormone therapy, most said it had a positive impact on their sexual relationships, and their partners also recognised the benefits. The treatment can not only improve your sex life, it also helps couples become closer and less isolated, as the survey showed. In fact, 60% of women using this treatment reported being more optimistic about the future of their sex lives, more confident, and sexually attractive.

“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 gynaecology oncologist and obstetrician. “Local oestrogen therapy is administered directly into the vagina, and can be given as either vaginal tablets, cream or ring.”


“Only small doses of oestrogen are needed to treat vaginal symptoms of menopause, and the vaginal response to local oestrogen therapy may be long-lasting, provided that you take it as indicated,” Dr Smith adds.

The package inserts for all oestrogens reflects oestrogen class labelling, there is no adjustment for oral versus vaginal therapy. Local therapy avoids most systemic adverse effects, as the oestrogen is absorbed locally in the vaginal tissue where it is needed. This results in low levels of oestrogen circulating in your blood stream, whereas oral tablets are broken down in your digestive system and liver, resulting in higher circulating blood oestrogen levels.

If you’re still wondering about treating troublesome symptoms, 74% of women using vaginal oestrogen tablets said they would recommend them, and 61% of these women reported that the treatment worked.

“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 to be embarrassed. Convenient treatments are available and consumers need to speak to their doctor or pharmacist about their options.”


South Coast Herald

South Africa



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