Women’s Vaginal Health - Sexuality and Aging
By: Sarah de la Torre, MD
Women’s intimate health tends to be a taboo subject. However, thanks to social media and an increasingly health-conscious population, women are starting to feel more comfortable about discussing their vaginal health.
After all, the vagina is a powerful organ. Not only is it a vital part of a woman’s sexuality, it plays a fundamental role in the creation of life. As women age, their vagina will too. They say with age comes wisdom – but with age comes intimate health problems too.
Female intimate health issues are much more common than we think. Vaginal health is intimately related to a woman’s overall well-being, which is why spreading awareness is so important. Here are some facts you should know about.
Sexuality and Aging; Intimate Health Problems in Older Women
As your body goes through life experiences such as childbirth and menopause, hormone levels change and your pelvic floor, a group of muscles and ligaments at the base of the pelvis, tends to weaken. The weakening of the pelvic floor muscles can cause a wide array of issues, including bladder leakage, pelvic pain, vaginitis, painful intercourse and more.
Some examples of issues that may arise as you age include:
Urinary incontinence is a common problem in women who have experienced childbirth and menopause. Who hasn’t experienced bladder leakage when coughing, sneezing or even laughing? This type of incontinence is called stress urinary incontinence and is mainly caused by pelvic floor muscle deficiency.
Stress incontinence occurs from weak muscles in the pelvic floor. Physical movement such as exercise, lifting heavy objects, sneezing or coughing puts pressure on the bladder and in turn, the urethra. Your urethra is the tube that carries urine from the bladder to the outside of your body; in other words, the urethra is all that stands between your bladder and the outside world. With sudden pressure, the urethra can no longer hold the urine in.
Urge incontinence is another type of urinary incontinence that happens when your bladder involuntarily contracts, causing a sudden need to urinate. It is also referred to as "overactive bladder".
Bladder control issues can affect daily life. Due to the embarrassment and inconvenience of the problem, some women even limit their social and physical activities all together.
Vaginal loosening occurs when your vaginal wall muscles loose their elasticity. Although some medical conditions can cause vaginal loosening, the main reasons are childbirth and aging.
Signs you may have vaginal loosening include urinary incontinence, reduced sexual pleasure, trouble achieving orgasm and difficulty gripping your finger with your vagina.
The symptoms related to vaginal loosening can have a significant impact on a woman’s daily life. Not only is urinary incontinence a cause of concern and embarrassment, but reduced sexual pleasure can cause a serious lack of confidence and intimacy issues with her partner.
Although there are several factors that can lead to vaginal dryness, it usually occurs when a woman approaches menopause. As estrogen levels decline, the blood flow in the vaginal mucosal tissue decreases and the inner walls become thinner and inflamed. This leads to decreased vaginal lubrication.
If you have vaginal dryness, you will most likely experience pain during sexual intercourse.
There are many reasons for vaginitis, including vaginal intercourse, douching, infections, allergic reactions to certain products and low estrogen levels. Low estrogen causes a form of vaginitis called "vaginal atrophy" and usually occurs when a woman breastfeeds or goes through menopause.
Pelvic pain, described as pain in the lower abdomen, should not be taken lightly. Women who experience pelvic pain may have a form of pelvic floor disorder or other serious reproductive or vaginal health problem that could cause significant physical, psychological and emotional distress.
Loss of Sensation
The degeneration of vaginal tissues and weakened pelvic floor muscles can lead to the loss of sensation during sex. If you have difficulty attaining and maintaining sexual arousal or experience pain or lack of pleasure during intercourse, chances are you have this vaginal health issue.
The loss of vaginal sensation can have devastating consequences on a woman's well-being: painful intercourse and the absence of pleasure can result in a decreased sex drive and lack of self-confidence.
How Common are These Issues?
According to a study funded by the National Institutes of Health, approximately 25% of American women suffer from some form of pelvic floor disorder. Check out the infographic below to find out more.
Turning Back the Clock
The weakening of pelvic floor muscles and the degeneration of vaginal tissues doesn’t have to mean a life of incontinence, vaginal dryness, pelvic pain and lack of sexual arousal and pleasure. Women of all ages should feel confident and be able to enjoy sex with their partner to the fullest.
Here are some things you can do to reverse the affects of childbirth and aging on your body and improve your overall vaginal health.
Strengthening Pelvic Floor
Strengthening your pelvic floor muscles is surprisingly easy. There are several options available, from specific exercises to device-based stimulation.
Exercises that boost pelvic floor performance include:
- Kegels: tighten your muscles as if you were trying to stop urinating, hold for a few seconds and release. Ideally, you should do 3 sets of 10 reps of Kegels per day.
- Bridge reps: lay on your back, knees bent with your feet pressed against the floor. Tighten your pelvic floor and lift your hips and hold for 10 seconds. Release and repeat 10 times.
- Wall squats: stand against a wall, with your feet hip-width apart. Engage your pelvic floor and lower into a squat for 10 seconds. Release and repeat 10 times.
- Jumping jacks: engage your pelvic floor while performing 30 to 60-second series of jumping jacks. Don’t forget to breathe!
An alternative to exercises would be device-based stimulation. Some devices use therapeutic vibration and heat to stimulate cell regeneration, restoring blood flow to the area and enhancing muscle function. This is virtually an effortless way to tone your pelvic floor muscles, which many women find more convenient than exercises.
Regenerating Vaginal Tissues
Regenerating vaginal tissues can be a painful and costly venture. Some women choose to undergo a vaginoplasty. A vaginoplasty, or vaginal rejuvenation, is a surgical procedure that aims to repair the soft tissues and tighten vaginal muscles that have been damaged by age or childbirth.
As for any surgery, there are several risks associated with anesthesia and cutting through tissue. The recovery time lasts several days and it can take up to 8 weeks to resume sexual intercourse.
Another option is laser vaginal rejuvenation. This is another procedure that must be performed by a certified doctor. The specialized laser is used to shrink the vaginal tissue and stimulate cell regeneration. Although this is a painless procedure, it’s expensive and must be repeated several times every 6 to 8 weeks.
There is, however, a third alternative that women may find more attractive due to its low risk, non-invasive nature. Photobiomodulation, or low-level light therapy (LLLT), uses light-emitting diodes (LEDs) to repair and regenerate tissues, reduce inflammation and improve nerve function. Less expensive than the surgical route, this procedure can be performed in the comfort of your own home.
If you have vaginal health issues, you shouldn’t shy away about talking about them with your doctor. Intimate health affects your overall health, which is why maintaining a healthy vagina should be a priority!
About Sarah de la Torre, MD
Dr. de la Torre is a board-certified OB/GYN, a fellow of the American College of Obstetricians and Gynecologists, and is considered a thought-leader among her peers in the field of gynecology and wellness. She has been a partner at a private Seattle OB/GYN practice group for over 10 years.
She received her medical degree from the University of New Mexico and completed her OB/GYN residency at the University of Washington. Dr. de la Torre published research on post-operative infection in the prestigious ACOG Journal and has served as vice chair of the OB/GYN department at Swedish Medical Center in Seattle, WA.