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Hi there Aunt Vadge,
I’m 47 and in good general health, other than intermittent anxiety. I’ve been married 23 years, but my husband and I haven’t been intimate in any way for the last three years.
I’ve had vaginal itching for over two years. I saw my doctor 14 months ago; he ran tests including a pap and STI screening, all negative, and prescribed oestrogen, which I didn’t take because of the cancer risk I’d read about.
My periods are generally regular, with one episode of spotting between periods. As I get older they’re more uncomfortable, and I pass small clots or thickened, mucousy-looking blood. I still get the genital itching. My skin is very dry, and oil to the area helps, as does Vagisil cream.
I went back to the doctor, who found discolouration of my cervix, and now I’m panicking with worry. I have a newer partner of 10 months; we’ve only ever had oral sex and used sex toys. I’ve had three partners in the last four years.
My question is: I know he doesn’t have an STI, so is there any chance I could? And if this were an infection from the toys, could he catch it?
Sincerely,
Discoloured
Dear Discoloured,
Straight to your questions. Yes – any genital contact since your last STI screen, including oral sex, fingers and shared toys, can pass an infection, so if you want certainty, ask for a full screen; your doctor already took swabs, so some of that may be underway. Toys are a low risk if you wash them well between uses, though an infection on a toy could in theory be passed on. But the thing I’d gently put on the table is this: what’s driving two years of itching and dryness at 47 is far more likely to be low oestrogen than any infection. The cervix colour is a separate question only your doctor’s results can answer, and most colour change is hormonal or inflammatory, not sinister.
Could you have an STI?
Yes, in principle. People often assume penis-in-vagina sex is the only real route, so they’re less careful with everything else, but oral sex, fingers and toys all move infections around, especially without a dental dam or condom. It’s less efficient than intercourse, but it happens.
If you want to stop wondering, the answer is a full STI screen rather than guesswork. Toys are a low risk when you wash them thoroughly between uses and between partners – but if a toy did carry something, it could pass it on, so washing is your friend.
The most likely reason you’re itchy and dry
At 47, with two years of itching, dryness and skin that feels better with oil, the pattern points hard at low oestrogen – genitourinary syndrome of menopause (GSM), the current name for what used to be called vaginal atrophy. As oestrogen falls, the vulval and vaginal tissues get thinner, drier and more easily irritated, and that itch-and-dryness combination is textbook. The fact that oil and Vagisil both help is a clue pointing the same way.
This is treatable, and it’s squarely the kind of root-cause work we do. Our guide to atrophic vaginitis and GSM is a good place to start.
About the oestrogen you were prescribed
You skipped the oestrogen because of the cancer risk, which is completely understandable – but it’s worth knowing there are two very different things called ‘oestrogen’ here. Local vaginal oestrogen (a small pessary or cream) works right where you put it, with very little getting into your bloodstream. That’s why it’s the standard treatment for menopausal dryness even for many women who can’t or won’t take systemic hormone tablets. It’s well worth going back and asking your doctor specifically about a low-dose local vaginal oestrogen rather than a systemic one.
On the natural side, plant oestrogens and soothing tissue-repair oils like fennel and sea buckthorn are used to comfort and rebuild oestrogen-starved tissue, and a plain emollient will ease the surface dryness (evening primrose oil soothes as an emollient, though it won’t reverse the atrophy on its own). We can help you put a local plan together if you’d like – just book in.
The cervix colour
The colour change your doctor saw is the one thing here that really does need their follow-up, not mine – we don’t examine cervixes. The reassuring part: a cervix changes colour naturally across your cycle and with your hormones. It can look reddish-orange, pale, redder with inflammation, or bluish in pregnancy, and all of that is normal. Colour change can also come from cervical ectropion (a harmless spread of the inner cervical cells) or from inflammation, and only rarely from anything sinister.
You didn’t say what colour it had turned, which would tell us more. Your pap will have checked for the cell changes linked to HPV, and the swabs for infection, so the real answer is to wait – anxiously, I know – for the results. If you want to understand what you’re looking at in the meantime, our guide to a normal cervix walks you through it.
If the itch won’t settle
One more thing for your back pocket: if the itching doesn’t ease once you’re treating the dryness, ask a doctor to rule out a skin condition like lichen sclerosus or lichen planus, which cause a persistent vulval itch and need a specialist eye. It’s not top of the list, but it’s the thing you don’t want missed.
Try not to let the worry run away with you before the results are in. When you know more, write again.
Warmest regards,
Aunt Vadge
This is general information, not a substitute for personalised medical advice.
