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Dear Aunt Vadge,
I’m a 58-year-old diabetic woman. I had a complete hysterectomy in 2005, and about six months ago I started having razor-like tears, itching, inflammation and bleeding around my vaginal area and in between and around my anus. It comes and goes, with only a couple of days in between. I saw my gynaecologist and all he did was take a pap smear, with no return appointment. My husband of 40 years was diagnosed with prostate cancer and is in treatment, so we’ve refrained from sex for about four months, but before then sex was unbearable with pain. Any information would be greatly appreciated.
Thank you,
Cut
Age 58, USA/New Mexico
Dear Cut,
Sorry to hear you’re both having a hard time with your health. It sounds rough.
You don’t mention what medications you’re on, or whether you’re getting any hormone support, which could be influencing your symptoms. My first thought is oestrogen, and my second thought is that you need a new gynaecologist. Minor cuts and tears can be encouraged to heal well with a vulva- and vagina-friendly cuts cream, though it sounds like there’s more going on.
Low or no oestrogen
When you’re menopausal and your vaginal area starts to itch, tear easily and get irritated, a lack of oestrogen is always an immediate suspect (atrophic vaginitis). As you’ll know, once the ovaries are removed or stop working, your oestrogen drops off, and with it the juice that fuels the suppleness and flexibility of your flesh.
This is especially noticeable around the vagina and vulva, because those cells are so responsive to oestrogen. It keeps them functioning well, and when you lose oestrogen you can lose a juicy, healthy, functional vagina. Other cells in the body respond to oestrogen too, but not nearly in the same way.
That means your problem – or part of it – could be helped with some oestrogen cream applied to the vaginal area. I’m very surprised your gynaecologist hasn’t looked into this in more detail; frankly, it sounds like a poor experience where your concerns weren’t taken seriously. So if you can, find a new gynaecologist and make an appointment straight away. If you’re stuck with this one, you’re well within your rights to insist he look into it properly and not fob you off.
Fungal infection
It’s possible your symptoms are caused by a skin infection, particularly yeast. There are times when yeast goes berserk and causes all sorts of trauma, so make sure you discuss this with your doctor, particularly if you’ve had ongoing yeast problems.
Being diabetic is worth factoring in here too: high blood sugar feeds yeast and slows tissue healing, so getting your levels well-controlled supports both the infection side and your skin’s ability to repair.
Ask about lichen sclerosus
One thing worth raising specifically with your new gynaecologist is lichen sclerosus, a skin condition that often appears after menopause as recurrent itching, whitening and razor-like splitting of the vulval and perianal skin – which fits your description closely. It’s diagnosable (sometimes with a small biopsy), very treatable, and well worth catching, so ask them to look for it as part of finding the true cause.
Dermatitis reaction
You may also have become allergic or reactive to something – perhaps your laundry detergent. Replace everything that touches your vulva with hypoallergenic versions, including soaps. Don’t use any douches, perfumes, creams or anything that hasn’t been prescribed by your doctor.
Diet
I’d also be looking at your diet, making sure your body has everything it needs to build strong, healthy flesh – protein and zinc in particular, but it all counts. If you need help, a nutritionist, naturopath or a dietician with a holistic bent can support your gynaecological issues in concert with your doctor. Your food intake really does matter when it comes to building healthy flesh.
Keeping juicy, once you’re fixed
Don’t forget that sex or masturbating keeps the vaginal cells juicy – it’s the only thing besides oestrogen known to keep the tissue functioning well when oestrogen fails. That isn’t always possible, obviously, but it can definitely help once you’re back to normal and out of pain.
There are also vaginal rejuvenation lasers that stimulate the vaginal cells to regenerate, which can work wonders on atrophic tissue.
You’ve definitely got something going on that needs addressing, but you need to be examined by someone who knows what they’re looking for and can take a detailed history to find the true cause – it may be more complicated than just oestrogen. If your doctors aren’t giving you satisfactory answers, find another, and get help from a naturopath or other practitioners who work outside the square of western medicine. Once you have a diagnosis, or if you have more questions, please write back.
Warmest regards,
Aunt Vadge
This is general information, not a substitute for personalised medical advice.
