Real Talk: What you Really Need to Know About Menopause

Menopause signals the end of your menstrual cycle, and for many women, this is cause for celebration. No more fussing with pads or tampons or worrying about embarrassing menstrual cup leaks.

Even if you're prepared for more common symptoms like intense hot flashes or hormonal weight gain, it's crucial to also recognize some lesser-known changes, particularly to your vaginal and vulvar health. While these symptoms may be uncomfortable, annoying, or shocking, rest assured you and your healthcare provider can work together to relieve, prevent or manage them.

To help make your experience a little less surprising, here are five vaginal and vulvar changes during menopause you need to know.

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More vaginal odor. Bacterial vaginosis (BV) is a common infection with a distinctive "fishy odor" caused by an overgrowth of "bad" bacteria in the vagina. Surprisingly, BV infections can actually increase with age. As estrogen levels drop, this can throw off the balance of the good and bad bacteria in your vagina and disrupt your overall pH.

So, if you notice a foul-smelling "fishy" odor coming from "down below," schedule an appointment with your healthcare provider, who can easily treat your infection with an oral or topical medicine. Also, use a condom to help limit recurrence.

Vulva Discoloration. Skin can change over time, even in the most intimate of areas. The hormonal fluctuations experienced during pregnancy and perimenopausal hormonal shifts can cause the skin on and around your vulva to darken. This darker pigmentation shouldn't cause concern since vulvas vary in color. But if you see any areas of your skin where it's redder or whiter than what's normal for you, or if you have a rash, warts, sores, lumps, or ulcers in the vulva area, follow up with your healthcare provider.

Vaginal Dryness. Your vaginal lining is usually flush with fluid which helps keep it thick and elastic. But with the natural decline of estrogen during menopause, the walls of your vagina become thin, dry, and sometimes inflamed.

Treating these symptoms may include prescription medications that work by either replacing or acting like estrogen in your body. Also, take the time to learn more about personal lubricants and find one compatible with the healthy range of your vaginal pH (3.8–4.5). Stay away from lubricants with color, flavor, or heating/cooling features since these can cause irritation or infection.

More UTIs. As you grow older, your bladder gets weaker and less stretchy. Your increased vaginal pH and lower estrogen also leave you vulnerable to urinary tract infections (UTIs). Sadly, women experience UTIs 30 times more often than men. Blame it on your shorter urethra, which gives germs easier access to your bladder

Besides frequent trips to the bathroom, here are a few common symptoms you should look out for:

·      Burning or pain when you urinate

·      Feeling like you have to urinate even though you have an empty or near-empty bladder

·      Urine that looks red or pink is a sign that you have blood in your urine

·      Pressure or cramping in your groin or lower abdomen

You should also be aware of specific symptoms that suggest that you may have an infection in your kidneys:

·  Chills and shaking

·  A fever higher than 101°F

·  Feeling tired

·  Night sweats

·  Nausea and vomiting

·  Pain in your side, back, or groin

·  Skin that's flushed, warm, or red

·  Mental changes or confusion

Be aware that it's possible to have UTI symptoms but, in reality, be experiencing an overactive bladder (a condition where you feel a sudden and urgent need to pee) or painful bladder syndrome (interstitial cystitis)- a chronic condition that causes bladder pressure, pain, and pelvic pain. So, see your doctor to get a proper diagnosis and treatment.

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Menopause comes with a fair share of symptoms. Some you are prepared to handle, while others, like changes to your vulva and vaginal health, may catch you off guard. Recognizing these changes and talking to your doctor about your concerns can only help to improve your sexual health for now and for years to come.

Janelle King is a Registered Nurse with a Master of Public Health. She has written articles for Sisters from AARP, The Body: The HIV/AIDS Resource, Modern Fertility, among many others, and featured in Women's Day Magazine. You can find her writing about reproductive health and wellness in her blog The Nurse Notein her spare time. Follow her on Facebook and Instagram @thenursenote.