Why does nobody talk about dryness? Premature menopause had me constantly irritated – this is how I dealt with it

Independent

4 days ago

At 40, I've had chronic illnesses like fibromyalgia and OCD for half my life, so I'm used to experiencing a lot of strange mental and physical symptoms. However, a few years ago, these symptoms multiplied.
I was experiencing things I'd never experienced before – crying randomly in the happiest places, an extreme fear of everything (when usually my confidence bordered on arrogance), a prickly numb sensation in my thighs, extreme body skin dryness and irritation, the list goes on.
I didn't know it yet, but these were all symptoms of menopause. A recent study by JSHealth Vitamins found that 90 per cent of women feel inadequately prepared for the symptoms associated with perimenopause. I know that if I'd been taught about the symptoms at school, or read more press coverage on menopause, I would have been able to identify what was happening to me a lot sooner.
It was the skin dryness and almost eczema-like irritation on my body that unlocked a premature menopause diagnosis for me. I had seen someone on Instagram who was going through menopause talking about using the same creams that my doctor had given me for my skin issues. Her doctor told her it was a menopause symptom. I was 39 at the time so menopause had never even entered my mind as a possible explanation.
The taboo symptoms of menopause
I had been on the 'mini pill' (progesterone only) for decades, which eliminated periods for me, so I hadn't even noticed any changes with my cycle. I Googled other menopause symptoms and discovered that I had been experiencing every single one, for years.
I immediately booked an appointment with my doctor for blood tests, and after two rounds of them several months apart, I was diagnosed with premature menopause and put on HRT. I was lucky – alarmingly, JS Health Vitamins found that 1 in 4 women felt their local GP was inadequately trained in menopause. By chance, I got a female GP who was up to speed and educated on the topic.
However, at the start of my menopause journey the one symptom I had been too embarrassed to seek help with was vaginal dryness. Like the skin on other areas of my body, the skin down there was extremely irritated, I experienced a burning sensation and it was sore to touch.
GP Dr Sophie Newton explains that, 'menopausal vaginal dryness is a symptom of what's medically called genitourinary syndrome of menopause (GSM). It's caused by a reduction in oestrogen levels, which affects the tissues of the vagina and surrounding areas. Without enough oestrogen, these tissues become thinner, less elastic and produce less natural lubrication.'
Over the next couple of months, the prescribed oestrogen gel that I applied to my arms and the progesterone capsules I took, transformed my life and reset me. But I was still experiencing hot flushes and vaginal dryness.
Hot flushes and excess sweating I could deal with, but the vaginal dryness was having a severe impact on my life and my sleep. At my first HRT review, I shared these symptoms, and I was prescribed oestrogen pessaries – a low-dose oestrogen tablet that's inserted into the vagina with a tampon-like applicator twice per week.
Dr Newton says that the crux of managing dryness is oestrogen. The pessaries I was prescribed helped relieve my vaginal dryness symptoms a little, but not enough. I was at the maximum dose and not able to increase how often I inserted one.
The effect this was having on my life was intolerable. I was constantly irritated down there, and it felt like permanently having a mixture of a urinary tract infection and thrush. GP and women's health expert Dr Milli Raizada explained to me that GSM, 'doesn't just impact your vagina and vulva, but also the urinary tract (urethra).'
This made total sense. I was raw and sore, and I had an annoying burning sensation with an incessant feeling of needing to pee, which kept me awake most of the night. Sex with my husband was off the table as it was uncomfortable, and if we did have sex, the irritating effects lasted for days afterwards.
How to treat vaginal dryness
I began experimenting with the help of 'Dr Google' and tried lots of things the internet suggested might be helpful – olive oil, ice packs on my labia, over-the-counter vaginal moisturising gel from a high street chemist – but I wasn't really getting anywhere. The ice packs did help me sleep temporarily, but that was it. The moisturising gel had the opposite effect and set the area on fire. 'Surely women don't just live with this?' I thought to myself as I searched for more treatments and solutions.
It took me a long time, and a lot of money, to find the products that worked for me, and to identify the things that increased the irritation. Dr Raizada explains that vaginal dryness symptoms are caused by a number of things, including 'less blood flow to the area, less oestrogen which changes the vaginal pH to more be alkaline, less oestrogen meaning less collagen and less elasticity, over washing the area, lifestyle factors like tight gym clothes and excess sweating, and certain medications. For example, antihistamines can worsen irritation too'.
We are all so unique and our skin might be different to someone else's, so it took a lot of trial and error to find the routine that allowed me to live comfortably again. It wasn't a quick fix and as Dr Newton explains, 'lots of soaps, feminine hygiene products, wipes and sprays are often not recommended as they can worsen genital dryness, itching and irritation.'
Like Dr Newton, I strongly encourage you to discontinue the use of any product that causes any kind of negative reaction. But I did eventually find an intimate care routine that worked for my skin – products that lubricated the area and left it comfortable, and products that soothed and cooled the skin, allowing me to resume a normal sleep pattern and enjoy sex again.
From loose cotton underwear to Andrex skin kind toilet tissue, all manner of things helped relieve my vaginal dryness symptoms. I now have my self care routine perfected and these are the products I'd recommend if you're also experiencing this lesser discussed symptom of menopause.
A gentle hydrating wash
Dr Newton advises that, 'even gentle washes can upset the vulval pH. Stick to water or a plain emollient.' This is usually the advice you'll hear from women's health experts, however, that approach just didn't work for me. It was only with a particular intimate wash that I got any relief.
Luna Daily creates its products with a team of dermatologists and, most importantly, gynaecologists, to ensure their products are safe for the delicate vulval area. The everywhere wash has a unique hydrabiome+ complex, which balances your vaginal microbiome and optimises its pH level. It also gives the area a large dose of moisture and supports the natural skin barrier.
Dr Raizada suggests this might have helped me because unlike many other intimate washes, the Luna Daily wash is 'fragrance-free and contains lactic acid, and prebiotics such as inulin to help support a healthy vaginal microbiome as well as soothing omega fatty acids and vitamin E to offer barrier support'. However, she also notes that it 'also contains glycerin, so for some, may trigger thrush and bacterial vaginosis'.
The other wash that I sometimes use, when I'm feeling luxurious, is Dr Barbara Sturm's V Wash. It too allows me to cleanse without irritation. It also soothes any existing irritation I may have with purslane extract and panthenol. Hyaluronic acid hydrates the area, and lactic acid helps the skin there to retain moisture, as well as supporting the area's delicate microbiome. There's also prebiotics and probiotics to maintain the intimate microflora.
Dr Milli Raizada says that this wash 'aims to support the vaginal pH and microbiome with lactic acid, lactitol, xylitol, lactococcus and probiotic ferments. Hyaluronate is aimed to be moisturising and panthenol to maintain the skin barrier.' She does make the same warning about the inclusion of glycerin though. Vaginal care products aren't typically 'sexy' or enjoyable to use, but this one feels like a luxurious treat and it looks great in my bathroom, instead of being hidden away like most of the other products I use in this area.
Cooling packs and sprays
While Luna Daily's soothing spray is intended for women who have had a vaginal birth, it has been so helpful to me in helping to soothe my vaginal dryness (GSM). I spray it directly onto the skin and it helps relieve irritation from inflammation. It's extra cooling and soothing if you keep it in the fridge. It's infused with soothing aloe vera and bisabolol, anti-inflammatory calendula, and microbiome supportive lactic acid'. Dr Milli Raizada says that it 'contains a soothing barrier, moisturising chamomile derivatives, and aloe vera and lactic acid as a vaginal microbiome pH support – which is helpful to sensitive vulvas in those with GSM.' She advises that you patch test this first though, as there is a potential that it could be an irritant to some. Dr Sophie Newton explains that this is because some sprays 'can sting or dry out sensitive vulval tissue.'
I already knew that my skin liked a cold pack, but the specific packs I now use were a god-send discovery. These Vagikool packs by Kegel8 are basically like ice poles for your vagina and relieve burning and itching, and reduce swelling post-intercourse.
Dr Sophie Newton agrees that this can be a useful product – 'a clean, reusable cold pack can ease irritation — just don't over-chill.' It's reusable and hygienic as you use a disposable shield over it each time, a bit like a condom. Dr Milli Raizada also agrees that it eases 'irritation from swelling, and burning symptom relief that people may get with GSM.' She says 'it's very safe and simple and can be used with other treatments.' It's been particularly beneficial to me to aid sleep when I'm experiencing annoying irritation down there, and after sex to soothe the skin and stop any pain or irritation developing as a response to it.
A specialist moisturiser
Most experts will recommend a topical moisturiser for the vulval area to soothe dryness during menopause but you should be very particular about the types of creams, oils and gels you use down there. The one I came to rely heavily on was the Naydaya vagina victory oil. Gynaecologist formulated, all-natural and fragrance-free, it was designed to soothe intimate skin and alleviate vaginal dryness.
All you need is a few drops and it's packed with soothing, nourishing oils and butters that have made me feel smooth and lubricated again. Pomegranate seed oil has omega 5-rich fatty acids, which protects dry, thinning skin and restores elasticity to vaginal tissue. Vitamin E is an anti-inflammatory and helps promote skin healing. There's also the natural emollient mango butter, as well as coconut oil, to moisturise and support the skin's natural moisture barrier. Dr Sophie Newton says that, 'natural oils can soothe some' but advises you to proceed with caution in case this causes irritation.
I'd also recommend using the Yes VM Organic vaginal moisture applicators. These single-use, fragrance-free moisturisers lubricate the inside of the vagina and restore a natural pH level. They also alleviate irritation, itching and burning and are especially useful pre and post intercourse. Dr Milli Raizada goes as far as to say she recommends these to all her patients, because they are 'an organic, non-hormonal, water-based, pre-filled and hygiene-certified internal formula that is pH balanced.' Dr Sophie Newton also says she recommends these highly as they're excellent for dryness and are clinically proven. I find them so easy to insert and instantly soothing.
A quality supplement
Finally, I've found that the right supplement can improve symptoms. I rely on the JSHealth Vitamins vaginal probiotic+ capsules to stave off irritation. These oral probiotic capsules contain four selected bacteria strains, providing 15 billion live cultures, and 20g of Cranberries in each capsule, to rebalance the vaginal microbiome. Dr Raizada explains that this can be a useful probiotic top-up in theory as, 'in menopause, lower oestrogen means reduced glycogen in the vaginal mucosal area, so a reduction in the production of lactobacillus.'
However, she and Dr Newton, note that more research is needed as there is a limited evidence base that a probiotic can help with symptoms of GSM. They note that some people do find it beneficial though, and whilst I can't wholly attribute the alleviation of my symptoms to these capsules, they don't do any harm and I feel more soothed and balanced than I did at the start of my journey.