Menopause changes "down south" - let's dive in!

menopause education Feb 02, 2023
A woman experiencing discomfort due to genitourinary syndrome of menopause

A few years ago, several church congregations in my area launched an initiative to gather menstrual period supplies to donate to local women's shelters. As I was announcing the details to a group of women at my church, one of the older women gasped in horror and disapproval. How could we possibly consider placing boxes of tampons and pads WHERE THE MEN MIGHT SEE THEM!?!?!?

My response could have been more compassionate. But it wasn’t. Oops!

I replied (in a tone that would have left my husband sarcastically saying, “So tell us how you really feel Rebecca”), “Nope, we’re not going to do that thing where we feel shame for a completely normal, natural process like menstruating, and we’re especially not going to hide our period products to make men feel more comfortable. They can deal with it.”

So why am I telling you this story?

To let you know that we’re not going to do that thing where we experience discomfort, pain, or chronic infections in intimate areas of our body and hide it in an effort to spare others (our partners, care providers, etc.) any sort of discomfort. We’re not going to suffer in silence and shame and let whatever pain we’re in impact the quality of our life because we're scared of an awkward conversation. Our loved ones and care providers can deal with it. No really, they can!

Here’s what we’re going to do instead:

We are going to normalize menopause-related changes in ALL AREAS of our bodies and the way that we’re going to do that is by talking about them openly and without shame. And, we're also going to normalize the idea that it's not okay for women to needlessly suffer. Got it?

With that out of the way, here’s how this 3-part series is going to work:

In this post, I’m going to give you a very brief and very basic rundown of “Genitourinary Syndrome of Menopause”. In the next post, we'll dive into vulva and vaginal issues. And in the final post, we’ll tackle urinary tract and bladder issues.

So, without further ado, let’s dive in!

What is Genitourinary Syndrome of Menopause?

“Genitourinary syndrome of menopause” or GUSM is the medical term for any of the changes you may experience to the vulva, vagina or lower urinary tract as estrogen declines during the menopause transition.

Why does it happen?

Some of the changes are due to age (like changes in blood flow and collagen) but most of the changes are due to declining estrogen, which keeps vulva and vaginal tissues lubricated, healthy and strong. As estrogen declines, muscles lose strength and tissues become more fragile.

What symptoms does it cause?

These changes can create symptoms like dryness, burning, or general irritation of the tissues. They can also cause painful sex and bladder issues including incontinence and recurrent UTI’s.

For many women, these changes will be manageable with a few over-the-counter interventions. But for other women GUSM can cause excruciating chronic pain.

How many women will experience it?

70-80% of women will experience genitourinary symptoms during the menopause transition.

What can be done to treat it?

Thankfully, there are TONS of safe options. Many are over-the-counter solutions, and some you’ll need to see a doctor or PT for. But the bottom line is: there’s hope! So, so, so much hope. We’ll dive into the specifics over the next two posts.

Anything else I should know right now?

Yep! Just one last important take away: GUSM symptoms tend to stick around for a long time. Don’t plan to “ride them out” and hope they get better. Dive into action as soon as you notice things changing. Future you will be so grateful you proactively took care of yourself!


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