Dear Aunt Vadge,
Can’t have sex because vulva tears in one spot. I use BHRT estrogen cream 3 x a week in vagina. Nothing helps.
Yours,
Split
Age 73, USA
Dear Split,
There are a few things you can do to help your vulva to not only heal, but for the tissue to become stronger as you age. Your low oestrogen may not be the only solution to your vagina woes. The combination of suggestions below may provide some relief.
Natural solutions to a low-oestrogen vagina
We love a product called Femular, which contains a herb called black cohosh. We also make our very own fennel pessary, Fennelope, which has an incredibly soothing, restoring blend of slightly oestrogenic fennel oil and seabuckthorn oil. A combination of these two is a wonderful start to caring for a menopausal vagina.
Caring for your adrenal glands in menopause
In menopause, the adrenal glands take over producing hormones, so if you were stressed going into menopause, you may have a low store of adrenal oomph.
Adding testosterone to your oestrogen cream1–3
Testosterone is part of a healthy vagina, as it strengthens the deeper layers. Ask your doctor to prescribe a combination of oestrogen and testosterone in your cream and see if that helps strengthen your vulvar tissue further.
The cream usually has a 0.1% testosterone component, with oestradiol 0.01%, in a base cream, which is compounded at a compounding pharmacy.
However, you’ll need to get advice from your doctor because you need to ensure your safety when using oestrogen products of any kind.
Everything your body needs to build strong skin
Your skin has structural components to it that, as you age, deteriorate. The elasticity of the skin is reduced due to a reduction in hyaluronic acid, collagen and elastin, so repeated tearing in older women, with wounds taking longer than ever to heal, can be a constant issue.
If you have the means, getting some dietary advice and personalised recommendations on tissue strengthening from a naturopath would be really useful.
There will be some simple signs that a qualified naturopath will be able to spot immediately in terms of what nutrients you may be missing, which contribute directly to healthy, strong skin.
- Zinc (signs of deficiency include a diminished sense of taste and smell, slow healing wounds, lowered immunity)
- Protein (signs of deficiency include flaky, soft nails)
- Digestive upsets that may indicate lowered digestive capabilities (signs include burping, bloating, gas)
Use of near-infrared (NIR) light4–6
Near-infrared is a pretty inexpensive and really interesting treatment, and because the issue is vulvar, you can use infrared light treatments from the outside.
Infrared treatments stimulate the skin cells, causing the mitochondria – the little energy factory in each cell – to pump up its energy production. This increase in energy provides the cell with more energy to do whatever it does best, and in this case, your skin will become stronger and ‘fitter’.
You can buy near-infrared lights online (make sure they specify near-infrared, not far-infrared, which won’t do anything), and they are often combined as a heat lamp, which brings blood and nutrients to the area.
Use the light for seven minutes every 2-3 days ongoing – more is not better when it comes to light therapy, as there is a sweet spot of regularity that your body responds to.
Too much and your mitochondria stop being stimulated. Not enough and it won’t do much.
Just keep up this routine as often as you need to, remembering that light therapy takes time to work – your cells will be stimulated, but they have to then produce the extra energy, and then bump up collagen production. This takes time, over weeks.
You can also use this treatment on other areas of your body that may need a boost, like a sprained ankle or arthritis. It works for any area on the body (that it can reach through to) that needs stimulating. Check it out online – there is plenty of excellent research into infrared and injuries. It’s pretty great.
Taking CoQ10 with or without your near-infrared treatments7
At the same time, you could take a CoQ10 supplement, with CoQ10 being a critical nutrient for your mitochondria to produce energy. Increased energy means faster healing and less splitting in future due to stronger tissue.
There are many things you can do to increase the performance of your tissue, but not all of them will work for you, so hunt around and keep trying.
Write anytime!
Warmest regards,
Aunt Vadge
References
- 1.Ninomiya N, Sekiguchi Y. 061 The Study of the Effectiveness of Topical Testosterone and Estrogen for Urinary Tract Symptoms of GSM. The Journal of Sexual Medicine. Published online May 1, 2022:S149-S149. doi:10.1016/j.jsxm.2022.03.595
- 2.Fernandes T, Costa-Paiva LH, Pedro AO, Baccaro LFC, Pinto-Neto AM. Efficacy of vaginally applied estrogen, testosterone, or polyacrylic acid on vaginal atrophy: a randomized controlled trial. Menopause. Published online July 2016:792-798. doi:10.1097/gme.0000000000000613
- 3.Davis SR, Robinson PJ, Jane F, White S, White M, Bell RJ. Intravaginal Testosterone Improves Sexual Satisfaction and Vaginal Symptoms Associated With Aromatase Inhibitors. The Journal of Clinical Endocrinology & Metabolism. Published online September 14, 2018:4146-4154. doi:10.1210/jc.2018-01345
- 4.Perez Marquez HJ, Schaefer AL, von Gaza H, Ambrose DJ, Cook NJ, Bench CJ. Evaluating automated infrared thermography and vulva exposure tracking as components of an estrus detection platform in a commercial dairy herd. animal. Published online August 2022:100585. doi:10.1016/j.animal.2022.100585
- 5.Zipper R, Pryor B. Evaluation of a novel deep tissue transvaginal near-infrared laser and applicator in an ovine model. Lasers Med Sci. Published online April 14, 2021:639-643. doi:10.1007/s10103-021-03315-z
- 6.Lanzafame RJ, de la Torre S, Leibaschoff GH. The Rationale for Photobiomodulation Therapy of Vaginal Tissue for Treatment of Genitourinary Syndrome of Menopause: An Analysis of Its Mechanism of Action, and Current Clinical Outcomes. Photobiomodulation, Photomedicine, and Laser Surgery. Published online July 2019:395-407. doi:10.1089/photob.2019.4618
- 7.Salehpour F, Farajdokht F, Cassano P, et al. Near-infrared photobiomodulation combined with coenzyme Q10 for depression in a mouse model of restraint stress: reduction in oxidative stress, neuroinflammation, and apoptosis. Brain Research Bulletin. Published online January 2019:213-222. doi:10.1016/j.brainresbull.2018.10.010
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