So…What About Lubrication???

lube

You hear all the time that during or after menopause, women tend to be “drier down there” and their ability to become lubricated is quickly diminished due to decreased estrogen in the body.  I hear women complain about a “sand paper” feeling in their vagina that they experience with simple tasks like wiping after going to the bathroom or with sexual activity, especially initial penetration during vaginal intercourse.

I can remember being in Whole Foods with my Aunt (age 62) and as we were picking up some other supplements, I pointed out the vitamin E oil.  I told her, frankly, it would help with any vaginal dryness, and that it was a great lubricant.  Now my Aunt is a total tree- hugging, all natural kind of gal, and she was all-out shocked by my comment!  Then, she laughed and said, “Good to know…”  I could tell she was slightly embarrassed.  This really bothered me because it wouldn’t be weird if I told her about a great lotion from Kiehl’s that I use on my face (yes, their tinted moisturizer is the best) but instead I told her what was good for her vagina, which I suppose isn’t usually a typical topic of conversation.  My point is that even though we all know that vaginal dryness goes hand in hand with menopause, we still don’t talk about it.

Now, you can only imagine that the same vaginal dryness is also NEVER talked about after having a baby.  You may not realize, but after having a baby and especially while breastfeeding, one’s estrogen is super low…again, leading to less lubrication. I will never forget the first time I heard one of the OB’s I work with tell his patient, “Congratulations! You just had your first child and although you are only 32, your vagina feels like it just went through menopause.”  I now say that all the time to my patients (wish I could take credit for that one) and every woman says the same thing, “I had no idea.”  This often-surprising side effect can stick around for up to a year after delivery (if you breastfeed that long; & longer if you breastfeed longer) so it can really take a serious toll on your vaginal health.

A measure of vaginal lubrication – natural or supplemental – is essential for most sexual activity, and certainly for vaginal intercourse.  A lack of adequate lubrication can often be a source of pain.   Not to mention, the lack of adequate lubrication could result in tiny micro tears along the inside of the vaginal lining, causing tissue damage and leading to soreness or spotting after intercourse.  Last time I checked, neither of those is very pleasant and not something you want your body to associate with sex.  Not only that but decreased estrogen often limits the ability of tissues to heal properly, especially relevant if there is scar tissue from any perineal tearing during childbirth.

No one can predict the amount of estrogen one will have post-partum and how the presence, or lack of this hormone can drive how your vagina feels.  The only thing we can do to combat this is be aware and take action to help your vagina feel like she is “back to her old self.”  This first thing I tell each of my patients is to use vitamin E oil at night once they are all healed from the delivery.  Vitamin E has excellent tissue healing properties and just a dime size portion rubbed just inside the vulva (the area just past your opening about a knuckle-length inside) can help rejuvenate the tissues and make things feel “more smooth.”  I’m continuously impressed with the positive results I hear about from Vitamin E use!!!

Increased blood flow also helps to lubricate our muscles and help to promote improved tissue healing.  This can come from total body blood flow, like walking, or more locally, from exercising your pelvic floor muscles…the right way.   This is a controversial statement, because so many women do their Kegels wrong and often do not relax their muscles with repetitive or prolonged muscle contractions.   The ability to relax your pelvic floor is just as helpful as the ability to contract, and is essential when it comes to increasing blood flow.  Further, the actions of our pelvic floor muscles – whether right or wrong – are intimately connected to our breath.  The “right” version is using the inhalation to draw down the diaphragm and facilitate pelvic floor relaxation or lengthening and the exhalation (blowing out) to facilitate any pelvic muscle contraction.

Lastly, there are sadly so many negative connotations associated with using “artificial” lubrication.  I hear from women all the time that it hurts their partner’s feelings or that it’s too weird to bust out in the “heat of the moment.”  If there is heat in the moment to begin with, I think vaginal dryness, discomfort, and pain would be more of a buzz-kill than reaching for the lubricant.  We need to understand that lubrication is a natural part of the female sexual response cycle is very helpful when trying to reach climax or orgasm, so where’s the problem in giving ladies a leg up when they need it?  There should be no shame in using lubrication, and in fact, I encourage it!

There has been a huge emphasis in this blog about the “menopausal vagina post-partum” but clearly you can see that any sort of switch in hormones can influence how your vagina is feeling.  This means a change in birth control or maybe a change in your thyroid function or treatments for vaginal cancers can lead to these same symptoms.  Take the time to listen to your body, and if it feels dry, make sure you take the time to lube it up!

-Vicky Yeisley

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