Advantages of Frequent Intimacy During Menopause Revealed
In the realm of women's health, Genitourinary Syndrome of Menopause (GSM) has been a topic of significant interest. This condition, characterised by a range of symptoms such as vaginal dryness, vulvar atrophy, urinary urgency or incontinence, itching, burning, pain, decreased lubrication, and changes in the skin's appearance, can impact the quality of life for many women.
A study involving over 900 Japanese women revealed that regular sexual activity may help maintain some sexual functions and symptoms, even as we age. However, treatment for GSM should not be limited to sexually active women, as it should be offered to anyone experiencing symptoms.
One common treatment for GSM is the use of local low-dose estrogen therapy. Clinical trials have demonstrated its safety and effectiveness, with minimal systemic absorption and no increased risk of breast cancer recurrence. This treatment has been particularly beneficial for alleviating bothersome vulvovaginal symptoms contributing to pain and avoidance of intercourse.
However, for those who cannot use estrogen, such as breast cancer patients, alternative treatments are available. CO2 laser therapy has shown promise, improving vaginal lining thickness, lubrication, and symptoms such as dryness and pain. Studies comparing CO2 laser therapy with vaginal estrogen have not found a statistically significant difference favouring one over the other, suggesting it could be a viable alternative.
Selective estrogen receptor modulators (SERMs), such as ospemifene, provide estrogen-like effects targeted to vaginal tissues without systemic hormone exposure, potentially offering symptom relief while minimising risks associated with systemic estrogen.
Regarding breast cancer risk, vaginal estrogen therapy has been cautiously avoided due to concerns about hormone sensitivity. However, recent expert opinion and regulatory review suggest that low-dose vaginal estrogen has localised effects with minimal systemic absorption and may not increase breast cancer risk significantly.
In addition to these treatments, water-based lubricants can be used before sex to reduce discomfort during intercourse for GSM sufferers. Vaginal moisturizers can also be used to restore moisture to the vaginal area, with external moisturizers helping the vulva area and internal moisturizers being inserted into the vagina.
It's important to note that pelvic floor exercises can improve vaginal blood flow and tissue elasticity to alleviate symptoms of GSM. A pelvic floor therapist can provide guidance and support with these exercises if needed.
Dr. Monica Christmas, associate medical director for The Menopause Society, emphasises the importance of diagnosing and treating GSM. She underscores the integral role of optimal sexual health in overall well-being and the impact these symptoms can have on women who aren't sexually active. She also highlights the effect of high stress levels on women's sex drive, as they can decrease testosterone levels, impacting sex drive and the body's production of DHEA, a hormone precursor used to produce estrogen and testosterone.
In conclusion, while local low-dose estrogen therapy remains a popular and effective treatment for GSM, alternatives like CO2 laser therapy and SERMs like ospemifene, along with non-hormonal moisturizers, provide options for those who cannot use estrogen. These alternatives may be particularly relevant for women with breast cancer concerns, as they potentially carry a lower breast cancer risk compared to systemic or vaginal estrogen therapy. Always discuss individualised risks and benefits with a healthcare provider.
- Local low-dose estrogen therapy has been shown to be beneficial for alleviating troublesome symptoms associated with GSM, promoting pain-free intercourse.
- For patients with breast cancer who cannot use estrogen, alternative treatments such as CO2 laser therapy and selective estrogen receptor modulators (SERMs) like ospemifene can improve vaginal health and alleviate symptoms.
- Optimising sexual health through treatments like pelvic floor exercises and the use of water-based lubricants and vaginal moisturizers can significantly improve the quality of life for women suffering from GSM symptoms, regardless of sexual activity levels.
