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Vaginal atrophy and the elderly lady.


It's a scary fact that vaginal atrophy will effect roughly 70% of ladies, with some specialists saying almost a 100% is nearer the mark simply because our vaginas, vulvas and bladders all age at the same rate as the rest of our bodies.


If you think about it it stands to reason.

We have all seen the fragility of ladies skin when a simple knock can result in skin that splits and takes a while to heal. Our vulval skin will age in the same way.

Yet for all those products available in chemists, supermarkets or on-line etc for sore, itchy or (as a certain advert likes to say) “bothersome” vagina there is a hidden danger in self treating when a visit to your GP should be sought. Some adverts might be seen as being irresponsible as they seem to encourage ladies to self treat... what if that “bothersome“ vagina is lichen scerlosus or vulval cancer?

A further concern of mine is to question what is happening to ladies in nursing homes?, in hospitals - especially long stay?, for ladies needing mental health care?, or with dementia?, or for those that have a disability?, or for those that have had a stroke and can't communicate? etc, etc. What happens when we can no longer take care of our own personal hygiene?


Well, from a small handful of specialists I have spoken to, the stats are pretty grim out there, imagine having vaginal atrophy, lichen scerlosus or vulval cancer and your personal care is minimal or non existent regards intimate vaginal and vulval care. Due to the aging process there's a pretty high chance of becoming incontinent. Wearing pads can provide a breeding ground for constant UTIs and basically nappy rash which is remedied during a change but the further vaginal care, to help prevent UTIs, is seldom available simply because the hard working care staff aren't able to provide proper care because they are simply run ragged on minimal wage.

What happens about the continued treatment of administering local oestrogen for ladies in such care, particularly for those who have been using it for years? Apparently nothing... It seems that no such care is considered. This maybe because staff can’t do or allowed to do such intimate care, or the ladies themselves physically can’t or, as I was told by some one, "because they don’t have sex anymore”. Local oestrogen isn’t just so you can have sex, it’s to help keep the vulva, bladder and vagina healthy. We all know how care homes can smell of urine, this is more than likely due to constant UTIs and/or a weakened pelvic floor. Local oestrogen, as part of elderly care, is VITAL (in my opinion).

We are living 30 plus years without oestrogen and all these products that are available tell you it’s a big problem for our urogenital health. We are told "don’t do this", "don’t do that", "eat this", "eat that"... so you live longer. So with that comes a duty of care to these ladies. Those that have had episiotomies and birthed the next generations, our bodies have endured all that hormones have thrown at us over the years.

Periods, cervical smears, childbirth whether vaginal or c-section, endometriosis, PND, contraceptives, hysterectomies etc etc the list is endless and I apologise for the many I will have left out, but we can’t allow these ladies to not be cared for in their later years, the only relief is a possible rubber ring to sit on, or maybe some amitriptyline.

To have dementia and not be able to communicate that basically your vulva is on fire is not an acceptable state for anyone to have to endure. My wish is that my book (Me & My Menopausal Vagina) spreads the word of these harsh truths by ending up on every GPs desk, every nursing homes staff room coffee table and anyone and everyone who works in elderly care so it plants that seed of... “Oh gosh I never thought of that”.

Because with longevity come different problems that have to be addressed and the care of the vaginal, vulval and bladder area of ladies in what ever form of care is extremely important and has to be part of the education system of all professionals working in this area, and IMO prevention is better than cure and local oestrogen treatment should be given as standard care long before we get to the nursing home stage. This also includes care in the home.

When visiting your elderly relative or friend ask them, “Are you sore in your vaginal area?“. We have to be able to ask such intimate questions.

There are care homes and care staff that are well aware and cater for these problems but these are the exception when it should be a national standard.

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