The Changes in Store for Your Vulva

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The Changes in Store for Your Vulva 

A lot can catch you by surprise when perimenopause arrives. Especially since most people haven’t been taught much about it. “All they think of is the hot flash,” says Jen Ashton, MD, chief medical correspondent for ABC News. But some of the most unexpected symptoms happen…downstairs. Meet genitourinary syndrome of menopause (GSM), which is (thankfully) no longer called vaginal atrophy — and can start long before menopause. 

Start from the beginning.

During perimenopause, estrogen levels drop, which makes your vulva and vaginal lining dry, thin, and lose elasticity. These symptoms can make sitting, having sex, and even wearing jeans uncomfortable, says Shoma Datta-Thomas, MD. You could also experience frequent peeing and more UTIs. Ah, womanhood. 

And how long does this last?

Perimenopause lasts four years on average — but can range from a few months to 12 years (!). GSM typically requires treatment to get better, but how long it takes for those treatments to work varies. That’s because estrogen decreases sporadically rather than in a “nice, slow, lovely, downward slope,” Datta-Thomas says. 

I have…feelings.

Same. If you’re wondering how you missed this in sex ed or your doctor’s appointments, you didn’t: “90% of women state they haven’t been educated at all about menopause in school,” says Ashton. Some doctors aren’t even thoroughly trained in it. “You're left feeling very alone and very unsure of what's happening in your own body,” says Datta-Thomas.

Your move

• Don’t “wait it out,” says Stephanie Faubion, MD, director of the Mayo Clinic Center for Women’s Health. Talk to your doctor if and when you notice any of the above changes. They can help you find the right treatment and rule out or diagnose other issues like an infection or skin condition.

• Don’t go it alone. Be honest with your partner or someone you trust about what you’re going through. Datta-Thomas also recommends speaking to a specialist who is experienced in perimenopause-related issues. 

• Explore treatment options like hormone replacement therapy, moisturizers, lubricants, and prescription medications.

Last week, we asked you to vote on a question to answer. The winner was:

What are natural ways to ease perimenopause symptoms?

FEATURED EXPERT:

Tara K. Iyer, MD, MSCP

Director of the Menopause and Midlife Clinic at Brigham and Women’s Hospital

It depends on which (of the dozens of) symptoms you’re experiencing. Two common ones are… 

Hot flashes or night sweats. Research shows that maintaining a healthy lifestyle, cognitive behavioral therapy, and clinical hypnosis can help reduce these symptoms.

Trouble sleeping. Focus on good sleep hygiene: Make sure your room is cool (around 65 to 68 degrees) and dark, limit caffeine to the morning, and avoid screens and big meals before bedtime. 

PS: Curious about whether supplements can help? We’ve got the answer. 

That’s on top of gaining an average of two to five pounds and experiencing other fun symptoms like hot flashes, mood swings, and insomnia. If that sounds frustrating, Noom can help. They use the power of psychology, technology, medicine, and human coaching to help build healthy habits you’ll keep for life. They even have a new dedicated mini-course that can help you overcome common challenges and stay motivated as your body naturally changes through perimenopause. Did we mention Skimm’rs get a free 14-day trial? Sign up now to get started.

"I have achieved a level of peace I didn’t think possible."

One woman on the positives of perimenopause. We’ll take any silver lining we can get.