Women who have had breast cancer treatment before menopause might find they develop symptoms such as hot flashes, night sweats, joint aches and vaginal dryness.These are symptoms of low estrogen, which occur naturally with age, but may also occur in younger women undergoing treatment for breast cancer. These changes are called the genito-urinary syndrome of menopause (GSM), which was previously known as atrophic vaginitis.
Let’s talk about why is estrogen important for vaginal health
- The vaginal area needs adequate levels of estrogen to maintain healthy tissue and keep the walls thick and elastic.
- When the amount of estrogen in the body decreases this is commonly associated with dryness of the vulva and vagina.
- Before menopause the vagina is acidic but after menopause the acidity (pH) changes and this may affect the resistance of the vagina and bladder to infection.
- The vulvar area also changes with aging, as fatty tissue reduces and the labia majora (outer lips of the vagina) and the hood of skin covering the clitoris may contract. If sensitive areas become more exposed, chafing can occur.
- Pelvic floor muscles become weaker and urination may become more frequent and difficult to control.
What symptoms occur with changes in vaginal health?
- Irritation, burning, itching, or chafing.
- Dryness due to decreased vaginal secretions, which may also mean sexual intercourse becomes uncomfortable or painful.
- Light bleeding, because the vagina may injure more easily. Any vaginal bleeding needs to be investigated by your medical practitioner.
- Inflammation which can lead to pain on urination and infection.
- Persistent, smelly discharge caused by increased vaginal alkalinity (higher pH) which is sometimes mistaken for thrush. Any vaginal discharge needs to be investigated by your medical practitioner.
How can I minimize irritation to the vagina?
- Wear underwear made of natural fibers such as cotton and change underwear daily. Consider going without underwear when possible e.g. going to bed.
- Avoid, or at least limit, time spent wearing tight-fitting underwear, pantyhose/tights, jeans or trousers as this may lead to sweating. Also limit time in a damp or wet swimming costume or exercise clothing.
- Wash clothing with non-perfumed or low-allergenic washing products. Avoid use of fabric softeners.
- Avoid use of feminine hygiene sprays and douching.
- Avoid pads, tampons and toilet paper which are scented.
- Avoid shaving or waxing the genital area, particularly if irritation is present.
- Gently wash the skin of the genital area only with plain water. Always pat dry (don’t rub).
How can pelvic floor therapy help?
Pelvic Floor physical therapy focuses on improving pelvic floor muscle strength & coordination to minimize the impact the loss of estrogen can have on your bowel and bladder function. We can educate you on further lifestyle changes you can make, like the ones above, to get you back to doing what you enjoy.
If you are experiencing bothersome symptoms, call us for a FREE phone call to talk with one of our pelvic floor therapists to see how we can help!
