Nearly a third of postmenopausal women experience vaginal changes, including dryness, itching and pain during sex — symptoms related to the declining levels of estrogen occurring during the transition to menopause. According to a study which included 745 postmenopausal women with vaginal symptoms, it appears that these symptoms may be more disruptive for women who are also suffering from depression. For depressed women, vaginal symptoms more significantly affected quality of life, emotional well-being and body image. Vaginal symptoms were also more distressing for women with urinary incontinence.
This is a common phenomenon. Those who are depressed are more likely to be bothered or distressed by physical symptoms. But it’s probably a two-way street, where women who have more physical symptoms are more likely to be depressed.
We tend to focus on vasomotor symptoms, such as hot flashes and night sweats, and sleep problems, but it may be helpful to specifically ask about vaginal symptoms in peri- and postmenopausal women. Hormonal replacement therapy (HRT) may help to alleviate these symptoms. For women who cannot or would prefer not to use systemic HRT (via patch or pill), other options include estrogen creams and various lubricants. (The Mayo Clinic website has some good information on treatment options.)
Ruta Nonacs, MD PhD
Hunter MM, Nakagawa S, Van Den Eeden SK, et al. Predictors of impact of vaginal symptoms in postmenopausal women. Menopause. 2015 Jul 13. [Epub ahead of print]