Welcome to Nether-Netherland, Where Everything Grows Old, Including Your Vagina
Everything I learnt about living with Vaginal Atrophy
It’s been a while, a long while, it’s been a month and what a month it was. I feel like we all needed a moment to breathe and recuperate. But now we’re back with a bang. A banger of a story by
. Menopause is the gift that keeps on giving. This piece is about a gift I hadn’t heard of. But it explains a lot. Thank you, Barbara, for educating us (and regaling us with your humorous approach to a sensitive topic.Three years ago, I got my first UTI. Having never had one before, I assumed I could wash it away with a combination of cranberry juice, barley water and Uva Ursi drops (recommended by a friend in a storytelling circle).
Nothing worked.
Two different types of antibiotics later and a couple of canceled storytelling circles (no one wants to have cystitis in a field with only a compost loo), it finally went away.
I was relieved, as the pun would have it.
Not long after, I was in the shower. Back then our shower ran like a menopausal woman, boiling one second, freezing the next, so while I flannel-washed daily like Kelly McGillis in Witness, I didn’t shower every day. This is important to know so you don’t think me a fool for not noticing sooner that all was not well in the netherlands.
Back to the shower: I was washing my (insert your favoured name for it, but for now, let’s call it what it is) vulva. Except I wasn’t. Like a dreadful Second World War film, it was flaps away. My labia had taken flight.
At first, I thought I was imagining it. I’d once had my bike stolen from outside college. I kept returning to where it wasn’t because I couldn’t believe it wouldn’t be there. This was like that.
Eventually, I asked my husband to look.
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‘Well, they’re there,’ he said, ‘just neater and more angry than normal.’ An image of Daphne du Maurier’s Mrs Danvers came to mind. I remained tight-lipped.
Like many facing medical panic, I took to Google before calling the GP on the basis that knowledge is power as well as solace.
After a straightforward, ‘Why do labia shrink?’ Dr. Google assured me that it was quite normal and there were things that could be done about it. Google exhausted, I made an appointment with the GP.
In the meantime, I needed something to read that would give me a greater understanding of what I was facing.
By training and inclination, I’m a researcher. Research not only distracts my mind but furnishes me with the right language to speak calmly. I certainly didn’t want to confront the GP with little more than a crazed, ‘Apparently, my fanny looks like a snooty housekeeper from a gothic novel.’
Research took me to a wonderful book called Me & My Menopausal Vagina* by Jane Lewis. Lewis is not a doctor or a scientist; in fact, she’s a retired florist, but through painful experience and study, she has become the expert on Vaginal Atrophy, which is what I discovered I had.
By the by, I hate that term so much, I’ve taken to calling it my withered vagina; withered meaning weathered, and I’m certainly that.
Lewis’s book is the only resource you’ll need if facing the same diagnosis. It’s funny, personal and (excuse the pun) no holes barred.
She talks about her symptoms, the treatments (some straightforward, some alarming) and the importance of talking frankly about VA. It’s only an ageing body part, after all, and we should be able to be open about it just as we are about failing eyesight, insomnia, brain fog, and grey hair.
A word of caution, Lewis has an extreme case of VA, so don’t be daunted. You may not suffer the same severe symptoms as she does, just as most mothers won’t suffer the horror-story births that friends are quick to regale them with. But forewarned is forearmed.
As Lewis asks:
Why don’t we know vital and, ultimately, life-changing information about our own bodies? About what to expect, how to manage it and how long it will last?
… I was not prepared to deal with this much pain in my later years. And according to my support groups, I wasn’t the only one. It seems that the words vaginal atrophy have somehow escaped our vocabulary, and even when they do eventually find their way to our lips we seem able only to whisper them in embarrassment, shame or confusion.
Looking back, my symptoms had started a few months before the UTI, and UTIs are often an indication of VA. I had begun to feel a burning when I used soap, and loo paper felt like sandpaper. I lost my pubic hair, which sounds like a good thing, but I’m a fan of a lush bush. Shouldn’t that rhyme?
And I also fell victim to ‘formication’ (not what you may be thinking), which is a severe itching of the outer labia that feels as though you’ve sat on a termite mound. I mistook mine for thrush, so I wasted time and pots of natural yoghurt on useless treatment.
By the time I realised something was wrong, nearly every part of my vulva had beaten a retreat. The pain was like an exposed nerve in a tooth but in a part of my body that rubbed on everything — knickers, seats, itself. On top of that, for me, at least, I had to deal with PGAD.
To save my blushes, I’ll let Lewis explain what that is.
Like a wizard’s robe, the clitoris has a hood over it, aptly named the clitoral hood, which should slide-n-glide nicely, protecting the clitoral gland. But, with menopause, this too can atrophy, exposing the extremely sensitive gland below. For a while, I even suffered from something called permanent genital arousal disorder (PGAD).
Happily, all my symptoms were vulvic (is that a word?) and not vaginal, so I’ve had no problem with sex, although, by necessity, it’s of the lusty, roll-in-the-hay variety rather than fiddlings and fondlings.
Once I made it to the doctor, she was attentive and supportive. She was prepared to listen and, more importantly, trusted I knew what I was talking about. She even took notes so she could help other women in the same situation.
Having spoken to her, I was prescribed topical oestrogen cream. She assured me — my mum had died of breast cancer — that the dosage for a whole year’s worth of cream would be less than one dose of HRT. We’re talking minuscule amounts, so if you’re resistant to full-on HRT, don’t worry.
Within a week my labia were plumping up, the itching had stopped, and my bush had become a shrubbery.
Longer lasting was the worry that every time I urgently needed to pee, I might have a UTI — I never want another one of those. I started to time myself between pees and then count how many seconds I was in full flow to make sure that each pee was normal. Three years on, I still do this, but it’s the only hangover.
Now three years down the line and having accepted I will always need oestrogen cream to lead a normal life, I can honestly say, as medical problems go, I’ve got off lightly.
My routine is straightforward: oestrogen cream every three days and moisturisers twice a day. And that’s it. No more onerous than putting in my contact lenses.
But, as with all things in life, there’ve been upsides and downsides.
One downside is that the two moisturisers I use, though not costly, are a regular expense I could do without.
Another issue, and only because I’ve never had to think of this before not being a ‘products’ person, is travelling. The oestrogen cream comes in a tiny tube, so no bother with customs, but the moisturisers need to be decanted into pots, having calculated how little I can get away for the amount of time I’m travelling.
Not having enough is unthinkable.
On the upside, I treated myself to expensive pure cotton underwear and spent never-to-be-disclosed amounts of money on 100% organic linen bedding. It’s worth it to keep the netherlands temperate.
As an unexpected bonus, I’ve lost all embarrassment about my menopausal body. I’ve learnt to love every nook and cranny, every wrinkle and pimple (yup, still getting those). It’s like the clock on Salisbury Cathedral that’s been working steadily since 1386. With a bit of tinkering, my body is still ticking along and to be marvelled at.
To those of you who have any of the symptoms of VA or have had a recent diagnosis, I would say, don’t panic, don’t be embarrassed, buy Jane Lewis’s book, and find a routine that suits you. All will be well.
Thank you for reading, you can find out more about me here.
If you’re feeling generous and would like to buy me a coffee (or, in my case, a pot of Marmite), you’ll find me here. I would be hugely grateful.
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