Vagina - Vaginal Dryness

Vaginal dryness is when there are fewer secretions and less tissue flexibility during sexual arousal, which can result in pain with intercourse. Women may also experience itching, burning and pressure sensations. Women who have been treated with chemotherapy report more vaginal dryness and pain with intercourse than women who have not been treated with chemotherapy.¹⁸ Studies have shown that vaginal dryness decreases satisfaction with the sexual experience.¹⁶

What is happening to your body
As a result of decreased estrogen, vaginal mucosa (the cells lining the vagina) gets thinner, there is decreased blood flow to the vagina and cells, causing less moisture. The result is less support and health to the cells in the vagina as well as to the skin. With a loss of estrogen, the folds and creases in the cells and skin in the vagina decrease, causing less flexibility in the skin, causing trauma to the area. It can also cause a decreased sense of pleasurable feelings during intercourse.

Urinary Tract - Incontinence and Infection Risk

You may experience the inability to hold back your urine in times of muscle exertion, such as with sneezing or vigorous exercise. This is called stress incontinence and may be a result of decreased estrogen. In addition, there may be increases in the number of urinary tract infections or irritations of the urinary tract that you get.

A second type of incontinence is called urge incontinence. This type of problem occurs when you feel as though you have to go to the bathroom very frequently. The bladder is easily irritated, causing premature contractions (feeling like you have to urinate when the bladder is not full).

What is happening to your body
There are estrogen receptors in suprapubic tissues or cells. A loss of estrogen can cause the bladder and urethral tissues to shrink, causing the potential for leakage. With decreased estrogen, muscle tone of the urinary sphincter muscles decreases also causing leaking urine. The pH, or acidity, of the vaginal tissues and secretions also change, making you more vulnerable to infections. Normal pH is 3.4 to 5.5. Higher levels occur after menopause.⁴²