After writing the article entitled “Menopause: Your Change, Your Life”, I received some feedback from Mary Wood, an Edmonton based Physiotherapist (Physical Therapist) and owner of CURA Physical Therapies. Mary offers services related to pelvic health.

The following is a summary of Mary’s comments.

Within three years of menopause, women may begin experiencing the symptoms listed below. Pelvic floor exercises known as Kegels, can help with all the symptoms when done correctly and regularly. If you have been doing them and they have not helped or you are unsure if you are doing them correctly, you should consult your physician or a Physical Therapist who works in the area of pelvic health.

• Bladder urgency
• Recurrent urinary tract infections
• Vaginal dryness
• Painful intercourse

Bladder urgency and recurrent urinary tract infections

Good bladder habits can limit or eliminate both potential problems and include:

• Drinking adequate fluids (toilet water after voiding should be a light lemon yellow color)
• Check for and limit bladder irritants in your diet (caffeine, citrus, aspartame, spicy foods). By eliminating the possible irritant for 5 days before reintroducing it in your diet, will allow you to determine the impact that it has on you.
• Normal voiding is 5-7 times in 24 hours (1 time overnight). Usually going every 3 hours.
• Should be able to hold 2 hours but don’t wait longer than 4 hours
• ALWAYS sit on the toilet (don’t perch or hover). Let nature takes its course, don’t push or strain.
• Don’t void (pee) just in case or if it has been within an hour.
• Limit the possibility of constipation by obeying the first urge to have a bowel movement.
• Talk to your doctor if the symptoms persist.

Vaginal dryness and painful intercourse

To reduce the symptoms of vaginal dryness you could try avoiding harsh soaps, over washing, dampness (hanging out in a wet swim suit), wearing non-chafing breathable underwear, using antihistamines and smoking.

We mentioned the three important key points to help with vaginal dryness and painful intercourse but got the order wrong! Moisturization should come before lubrication. Both of which will make utilization easier!

1. Moisturization

Several non-prescriptive moisturizers include:

• Replens
• KY Moisture Beads
• Vitamin E (before you go to bed at night)

These products can and are often used throughout the rest of a woman’s life.

2. Personal Lubrication (non-prescriptive)

Personal lubrication can be considered for any genital sexual activity. There are numerous products on the market which include:

• Lubrin
• Glide

Some individuals have experienced negative reactions to the warming lubricants. It is recommended that you use them cautiously.

Some of the prescription products available include:

• Estring: contains estradiol; one ring lasts 3 months
• Premarin Vaginal Cream: contains conjugated estrogens; to be used cyclically, i.e. 3 weeks on/1 week off or as directed by your physician
• Vagifem: estradiol in vaginal tablet insert form; insert daily for 2 weeks, then twice weekly or as directed by your physician

3. Utilization

Regular sexual intercourse helps maintain pelvic health. However it may not be possible for a variety reasons affecting either partner or the lack of a partner. Some women experience vaginal shrinkage. Options include manually stretching the opening on your own, use of a vibrator or use of devices like epi-no.

Women experiencing pain or bleeding during or after sexual intercourse should talk to their doctor.

As health care professionals we should ensure that our female clients are healthy in all aspects of their lives!