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SYMPTOM · PERIMENOPAUSE

Vaginal dryness

A feeling of discomfort, tightness or dryness, sometimes bothersome day to day or during sex: vaginal dryness affects the vast majority of women, yet it's still rarely talked about.

WHO IT AFFECTS
Up to 8 in 10 women after the menopause
AVERAGE DURATION
Tends to get worse over time if left untreated
CAN LAST
Can be treated effectively at any point

Why it happens

Oestrogen keeps vaginal tissues thick, elastic and naturally hydrated. As levels fall, those tissues thin and natural lubrication decreases, which can cause discomfort, irritation and sometimes mild pain during sex.

What tends to make dryness worse

  • Perfumed or irritating soaps in the intimate area.
  • Synthetic underwear, which is less breathable.
  • Smoking, which reduces local blood flow.
  • Not being well hydrated in general.

In the moment

  • Use a water-based lubricant during sex.
  • Avoid vaginal douching and perfumed products.
  • Choose cotton underwear.

Day to day

  • A vaginal moisturiser used regularly can bring lasting relief.
  • Drink enough water throughout the day.
  • Don't hesitate to talk about it: there are local treatments and they work well.

Still uncomfortable despite the changes you've made?

A healthcare professional can suggest local treatments tailored to you, often very effective and easy to fit into your routine.

For information only. This does not replace a personalised medical assessment.

If several of these symptoms ring true, it's no coincidence.

Menopause isn't just about hot flushes. Symptoms can begin years before your last period and affect sleep, mood, energy, memory, weight and intimate health.

Click on a symptom to find out more.

Brain fog

You search for words, reread the same sentence twice, lose the thread mid-conversation. Nothing to worry about: your brain is simply running slower, with less glucose to fuel it as oestrogen levels fall.

Sleep problems

Asleep in ten minutes yesterday, wide awake at 3 a.m. today, for no reason. Progesterone, which helped you switch off at night, is in shorter supply, and deep sleep takes the hit straight away.

Anxiety

Stress that spikes over an email, a meeting, running ten minutes late. Oestrogen affects serotonin: when it yo-yos, everything feels heavier to carry than before.

Joint pain

Knees that creak as you stand up, hands that feel stiff in the morning. Cartilage loses its best anti-inflammatory ally as oestrogen falls, and you feel as if you are rusting up all over.

Hot flushes

A wave of heat rising from the chest to the face, lasting one to five minutes. Deprived of oestrogen, the thermoregulatory neurons in the hypothalamus narrow the thermal neutral zone: a few tenths of a degree are enough.

Palpitations

Your heart suddenly races, with no effort and no reason. Oestrogen also influences the nervous system that sets your heart rhythm. Alarming in the moment, rarely serious.

Mood swings

You laugh, and thirty seconds later you could cry or tell everyone where to go. Hormones rise and fall faster than before, and your mood follows, without warning.

Weight gain

Your tummy rounds out even though nothing on your plate has changed. Oestrogen redirects fat storage towards the abdomen, and your metabolism runs a little slower than before.

Low libido

Desire takes longer to arrive, or barely arrives at all. Oestrogen and testosterone fall, and sensitivity with them. The desire is still there; it just takes longer to get going.

Irregular periods

One cycle shorter, another dragging on, a month skipped altogether. Ovulation becomes less regular as the ovaries slow down. It is often the very first sign of perimenopause.

Night sweats

Waking up drenched in the middle of the night, sheets to change, sleep cut short. It is the same hot flush as during the day, night-time edition, and it wakes you just as surely.

Pain during sex

Discomfort, sometimes real pain, during or after sex. Tissues thin as oestrogen falls, and what never used to be a problem can become sensitive.

Dry skin

Skin that feels tight, marks more easily and seems to have lost some of its bounce. Collagen declines with oestrogen, by up to 30% in the first few years after menopause.

Chronic fatigue

Tiredness that will not lift, even after a good night. Broken sleep, falling hormones: your body runs less efficiently, and you feel it from morning to night.

Hair loss

More hair in your brush, a parting that seems to be widening. Oestrogen used to extend its growth phase. Without it, the cycle shortens and each strand gets finer.