Medically Reviewed by Paul E. Chandler, MD

Women and their partners are often faced with vaginal dryness after a hysterectomy or after a woman is past menopause. McLeod Gynecologist Paul Chandler, MD, discusses what you can and should NOT do to help the problem:

Here are key points from Dr. Chandler:

When a woman has a “total hysterectomy” — where everything (uterus, fallopian tubes & ovaries) has been taken out, the amount of estrogen left in the body is low. That causes the lining of the vagina to thin and become less elastic. That is called “vaginal atrophy.”

When the vagina becomes dry and less elastic, painful intercourse can result. The woman’s vagina will be dry and will not stretch. Also, those tissues tend to scar and shrink from lack of estrogen.

One of the treatments for this development would be to use some vaginal estrogens. Very little of it gets absorbed. So, it’s very safe. I’ve even used this treatment for women, who’ve had breast cancer, because there’s so little of the estrogen that is absorbed. But it does thicken those vaginal tissues up and makes them more elastic, helping reduce painful intercourse after hysterectomy.

Sometimes a woman might have very bad endometriosis. This condition is where some of the blood and uterine lining from a woman’s period, rather than going through the vagina, it goes through the fallopian tubes and ends up in the woman’s abdomen. The lining is still alive and can implant on the pelvic organs, causing scarring of those pelvic tissues. Even though this woman has had a total hysterectomy and had all the organs removed, the scar tissue can recur. During intercourse, there can be pain from the manipulation of that scar tissue.

In post-menopausal women or women who have had their ovaries removed and have low estrogen levels, a vaginal lubricant for sex helps a lot.

Don’t use Vaseline, because that can actually make the pain worse. Don’t use K-Y Jelly; this lubricant is designed for office examinations.

Use a water-based or a silicone-based lubricant. A good one that I recommend to patients is called Astroglide. (You can find that at Wal-Mart). The best ones are water-soluble lubricants, and they make a huge difference for those women in menopause or those women who have had a hysterectomy and no longer have adequate estrogen levels.

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Findings suggest that addressing those risk factors may help sleep disruptions giving hope to women that sleep symptoms may not last past menopausal transition. Sleep issues are one of the most common reason menopausal women seek medical assistance as it is a huge burden on quality of life, but it is also a huge burden on health care making investigation of underlying causes very important.

Data was analysed from the Midlife Women’s Health Study involving 776 women aged in the age group of 45-54+ for a 7 year time frame. The participants provided annual blood samples and survey for the use of tracking sleep patterns and disruptions, as well as other menopausal symptoms and hormonal levels as the participants transitioned from pre to post-menopause. Tracking of poor sleep was done by asking questions about the frequency of sleep disturbances, insomnia, and restless sleep.

No correlation was found between the likelihood of reporting poor sleep before menopause, during, and after. Meaning that women that reported sleep problems changed as they were transitioning to different stages of menopause, such as reporting insomnia during was not more likely to have insomnia after.

Analyzing data for any other symptoms and factors that may be associated with poor sleep it was found that depression and hot flashes were strongly associated with poor sleep across all stages of menopause transitioning. These 2 risk factors varied in reporting frequency across all stages, which may help explain why poor sleep also varies.

Self reporting is not as precise as a clinical sleep trial but is more useful because it is more accurate to their experience. This study is hopeful for most women as it suggests that sleeping patterns may change but it may not be permanent.

[W]e are only beginning to understand is why women are more susceptible [to Alzheimer’s]. What factors differentiate women from men, specifically as we reach middle age?

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It turns out that menopause affects far more than our childbearing potential. Symptoms like night sweats, hot flashes and depression originate not in the ovaries but largely in the brain. These symptoms are all caused by an ebb in estrogen. The latest research, including my own work, indicates that estrogen serves to protect the female brain from aging. It stimulates neural activity and may help prevent the build up of plaques that are connected to the onset of Alzheimer’s disease. When estrogen levels decline, the female brain becomes much more vulnerable.

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The good news is that as women mature into their 40s and 50s, there seems to be a window of opportunity when it is possible to detect early signs of higher Alzheimer’s risk — by doing a brain-imaging test, as we did — and to take action to reduce that risk.

There is increasing evidence that hormone replacement therapies — mainly, giving women supplemental estrogen — can help to alleviate symptoms if given before menopause. We need much more research to test the efficacy and safety of hormone therapy, which has been tied to an increased risk of heart disease, blood clots and breast cancer in some cases.

Read full, original post: The Menopause-Alzheimer’s Connection