Vaginal Health After Menopause: Why Your Vaginal Health Matters More Than You Think
Let’s face it, you may not think too much about your vagina until you notice discomfort, there is an unpleasant smell or something seems “off.” Burning during urination, cloudy or dark urine, and lower abdominal pressure are not normal and may be signs of a urinary tract infection.
Given that 50% to 80% of women face a UTI at some point in their lifetime, if you have had one, you are probably accustomed to treatment with antibiotics to clear it up. However, as you age, the incidence and risks associated with UTIs climb significantly due to menopause. Let’s get into the details and offer solutions to prevent the potentially devastating effects of a UTI.
Prevalence of Urinary Tract Infections Among Older Women
According to the CDC, the prevalence of Urinary Tract Disorders for older adults is:
6.8% among adults aged 65–69 years (range: 6.6%–7.0%)
8.2% among those aged 70–74 years (range: 8.0%–8.4%)
10.0% among those aged 75–79 years (range: 9.6%–10.2%)
11.8% among those aged 80–84 years (11.2%–12.2%)
14.3% among those aged ≥85 years (13.5%–14.7%)
UTIs are associated with substantial health care costs in the United States, including direct costs such as outpatient visits, laboratory testing, medications, and hospitalizations, as well as indirect costs from productivity loss and complications due to recurrent infections.
What Happens to the Vagina During Menopause?
It is estimated that 86% of women have vaginal atrophy after menopause due to declining estrogen levels, leading to an increased risk of vaginal and bladder infections.
Estrogen supports beneficial bacteria in the urethra, but lower estrogen can allow harmful bacteria to flourish. An infection can spread to the kidneys or cause sepsis, which is a life-threatening response to an infection that can lead to tissue damage, organ failure, and death. As many as 30% of sepsis cases start with a UTI.
Septic shock has a mortality rate of 20% to 40%, which increases up to 50% in vulnerable older populations.
Vaginal health ( like many other medical conditions) is often overlooked as women age. Here are some of the changes associated with menopause:
Menopause brings a significant decline in estrogen and testosterone.
Vaginal tissues are particularly sensitive to these hormonal changes.
Lower estrogen levels cause the vaginal walls and tissue to become drier, thinner and more fragile.
The vaginal pH shifts to a higher more alkaline pH which can raise infection risk.
Intercourse may become painful due to lack of moisture and fragile tissue.
Your Vaginal pH Is a Big Deal
At a healthy reproductive age, vaginal pH is typically acidic, around 3.8-4.5. This acidic environment supports a healthy vaginal microbiome. The most prominent healthy bacteria in the vagina is Lactobacillus. This is the bacteria we want to keep happy. Here is some of what happens to pH levels during menopause:
pH starts to increase, making the microbiome more susceptible to bad bugs.
Introduction of anything that goes in the vagina (penis, sex toys, lube, etc.) disrupts the vaginal biome.
When we were younger, our healthy hormone levels helped reduce the risk of infection.
As we age, declining hormone levels make it much more challenging to bring our vaginal environment to a healthy pH level.
What Can Help Support Vaginal Health after Menopause?
Supporting vaginal health is one of our goals at Optimal Hormone Health. We have several suggestions and are here to work through the best solution for your specific situation.
Vaginal estrogen
Vaginal estrogen helps restore vaginal pH by doing the following:
Restores vaginal tissue by rebuilding thin, dry vaginal walls caused by low estrogen levels.
Feeds good bacteria by increasing glycogen production, which Lactobacillus uses as fuel.
Boosts lactic acid to lower and balance pH levels.
Prevents infections by lowering acidity, stopping bad bacteria from developing, and reducing urinary tract infections.
Vaginal Moisturizers and Lubricants
Vaginal lubricants can support overall tissue health and help prevent UTIs.
Moisturizers can provide ongoing relief from dryness.
Lubricants can reduce friction during sexual activity and prevent microtears.
Choose products that are appropriate for vaginal use and avoid unnecessary irritants.
Boric Acid
You may have never heard of boric acid suppositories, but they can be a very effective way to restore pH levels. Boric acid:
Can treat stubborn yeast infections.
Can calm Bacterial Vaginosis by lowering pH levels.
Can help reduce vaginal odors linked to high pH levels.
Talk with us about our recommended Boric Acid products.
Vaginal pH Testing
The convenience of tracking pH levels at home can help you track how acidic your vagina is and possible signs of a bacterial infection. Vaginal test strips do the following:
Check if your vaginal fluid is in the normal, healthy acidic range (usually 3.8 to 4.5).
Help determine whether symptoms like itching, burning, or a bad odor may be linked to a bacterial infection.
Shows when the vaginal environment becomes too basic (above 4.5), which lets bad bacteria grow
Protect Your Vaginal Health as You Age
Your vaginal health affects your overall health and deserves attention, especially as you age. Talk with us about any vaginal changes that you may attribute to normal aging, but could be setting the stage for urinary tract infections. Remember:
Menopause doesn't mean vaginal health has to deteriorate when appropriate and successful interventions can restore pH levels and prevent urinary tract infections.
Recognize symptoms early. Don’t wait hoping things will improve without treatment.
Talk with us about persistent dryness, pain, recurrent UTIs, unusual odor, bleeding, or other vaginal changes.
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