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Join the 4 percent! There’s help for vaginal dryness

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Join the 4 percent! There’s help for vaginal dryness.

During my recent webinar on vaginal and urinary health, I encouraged women who avoid sex because vaginal dryness makes it uncomfortable and painful to share this fact with their partners.

I asked them to put themselves in their partner’s shoes:  “How would you feel if your partner doesn’t want intimacy and sex anymore? What would you think? That your partner is no longer attracted by you? Doesn’t love you anymore? Has a lover? That you don’t turn him/her on? You’re no longer sexy?”…

The next day I received an email from a woman who attended the webinar, thanking me for suggesting she explain to her partner why she’s been avoiding sex. She said that after the webinar “I shared with him about my discomfort and dryness issues and told him that I do love him and that I am not having an affair.  I think he was really relieved. Good advice”!

It may be difficult to start this conversation and to explain what you are experiencing, so here are some tips to “Talking with your partner”.

You can watch the recorded webinar free with a WHIM (Women’s Health in Midlife) Network 2020 membership, which is now on sale.

Vaginal dryness is more likely to happen when estrogen levels are low.  This can happen due to natural menopause (including during perimenopause), and due to induced menopause such as surgery to remove the ovaries and certain cancer treatments that affect the ovaries.  Vaginal dryness can also occur while breastfeeding, during periods of stress, when using certain medications for the treatment of fibroids or endometriosis, and when taking antidepressants and some cold and allergy medications.

You may notice lack of lubrication, decreased arousal, and difficulty achieving orgasm. Penetration may cause pain because the vaginal opening has become narrower, the lining of the vagina is thinner and less elastic, and the vulva and clitoris may even shrink without estrogen. This cluster of symptoms is called vulvovaginal atrophy (VVA).

Around 50% of women are bothered by these symptoms but only 4% receive treatment. Why do you think that happens?

Several reasons come to mind:

  • Women assume this is part of aging and there’s nothing they can do about it; it’s just something they must put up with
  • Women don’t know help is available
  • Women don’t know where to go for help
  • Women don’t know what to buy to alleviate their symptoms
  • Women suffer in silence and don’t complain to their doctors about their symptoms

Vaginal discomfort affects a woman’s sexuality and self-esteem, upsets the relationship with her partner, and decreases intimacy, sexual desire, and quality of life.

It’s not only sexually-active women who are bothered by vaginal and vulvar changes due to decreased estrogen. Many women feel uncomfortable riding a bike, sitting for prolonged periods, or wearing tight clothes.

Don’t be one of the 96% of women who receive no help for their vaginal symptoms. Join the 4 percent!
There are many therapies to help VVA symptoms:

Regular sexual stimulation

This increases blood flow and lubrication. Remember, if you don’t use it, you lose it!

Over-the-counter products

  • Vaginal lubricants (non-hormonal) can be used during intercourse to add lubrication, reduce friction, and improve pleasure. They can be water-based, silicone-based, mineral oil-based, or plant oil-based.
  • Vaginal moisturizers (non-hormonal) are designed to adhere to the vaginal mucosa, allowing cells to retain moisture. They are applied regularly to the vagina and vulva, and are longer-acting than lubricants. An example is Repagyn, an ovule containing hyaluronic acid, a substance that provides moisture and a soothing effect. This product is behind-the-counter meaning you must ask the pharmacist for it.

Do not use products that have added flavours, a warming sensation, or are scented, because these can cause irritation. As with many things in life, but especially with products you use on your vulva and in your vagina, less is better.

Pelvic floor therapy

Sometimes the pain is caused by very tight pelvic muscles rather than by thin and dry vaginal tissues. A physiotherapist specializing in pelvic floor therapy (PT) may be very helpful. Even during COVID you can book a FREE Virtual Discovery Pelvic Health appointment.

Low-dose vaginal estrogen

Lubricants and moisturizers may not be helpful, or they may stop being helpful, because they add lubrication and moisture to the area but do not treat the thinning of the vaginal tissues which tends to worsen over time. The most effective treatment for VVA is local estrogen, which is available on prescription as a cream or a vaginal ovule.

If low-dose estrogen vaginal therapy is recommended for you, do not be put off by the warnings and precautions on the accompanying product insert. Due to their low dose, the systemic (affecting the whole body) absorption of the estrogen is very low, much less than if you were taking an oral pill, for example, and the adverse effects are less likely too. But, for many reasons, the information in these low-dose vaginal products doesn’t reflect that difference and instead lists the same warnings and precautions as for the oral products. It doesn’t make sense. I, and many other experts, believe these warnings do not reflect the best scientific knowledge. Many groups advocating for women’s health are trying to get the FDA and the manufacturers to change the information in these pamphlets.

Prasterone

This is a non-hormonal vaginal ovule therapy, and a new therapy in Canada.

Ospemifene

This is a a non-hormonal oral tablet expected to be available in Canada sometime in 2020.

Laser

This treatment is done in the doctor’s office and is fairly expensive.

Which therapy should you choose?

Usually, unless VVA is severe, lubricants and moisturizers should be used first.

If these products do not help—or they stop helping—then your next therapy options should be based on the severity of symptoms, contraindications for therapy, medical conditions, medical history, and your personal preferences. A ten-minute physician’s visit usually isn’t enough to go over everything that needs to be addressed.

During my 45-minute Vaginal & Sexual Health Care Package we go over your challenges, symptoms, concerns, what you are experiencing, what you expect from treatment, your preferences, and what the best therapy for YOU and your symptoms will be.

Women’s self-esteem, quality of life, and relationships suffer when vaginal dryness and painful sex aren’t addressed. Stop suffering alone and in silence. Join the 4 percent! There’s help. I can help you!

Teresa Isabel Dias is a pharmacist and a menopause practitioner (NCMP) certified by the North American Menopause Society (NAMS), she lives in Toronto but all her services are available online – one-on-one consultations, live workshops, and webinars. Sign up for her free biweekly MenopausED Newsletter to learn more about menopause and women’s health.

BioIdentical Hormones – Be Informed! Part 1

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BioIdentical Hormones – Be Informed!

Bioidentical hormones isn’t a scientific term and it means different things to different people. The Endocrine Society defines bioidentical hormones (BH) as “compounds that have exactly the same chemical and molecular structure as hormones that are produced in the human body.” The FDA (Food and Drug Administration) doesn’t recognize the term bioidentical and regards it as a marketing term. NAMS (North American Menopause Society) states that bioidentical “refers to all hormones that are chemically identical to those made in the human body” and “some well-tested, government-approved, brand-name prescription hormones meet the definition of bioidentical”. There’s no official, standardized definition for bioidentical hormones and this causes a lot of confusion and misinformation. Some women believe:

1. Bioidenticals hormones are compounded in a pharmacy and therefore are different from hormones manufactured by pharmaceutical companies.
2. BHT is natural, therefore is safe
3. BHT is made from plants or herbs, like yams, soy or chasteberry and doesn’t contain hormones

 

I have not been paid, endorsed, or subsidized by any pharmaceutical company or compounding pharmacy to write this blog. My intention is not to endorse a particular product over another, my goal is to educate, bring awareness, inform, and demystify some common beliefs about bioidentical therapy (BHT). I will write several blogs on the topic and in the first I’ll try to answer the following question:

1. Are the bioidentical hormones (BH) used by local pharmacies to compound formulations different from the BH used by pharmaceutical companies in commercially-available products?

Estrogens, (estradiol, estriol and estrone), progesterone, and testosterone are some of the hormones produced by the human body. Medications that provide any of these ingredients can be considered bioidentical. Several pharmaceutical companies manufacture commercially-available medications that contain some of these hormones. There are no hormones in the wild that can be used by women straight from the plant source. The source of the bioidentical may be a plant like yams or soybeans, but in order for it to have an effect in the human body it has to be synthetized and converted into a chemical with a structure similar to a human hormone. This is done in a few laboratories in the world- they synthesise plant extracts into hormones and sell them to pharmaceutical companies and compounding pharmacies which in turn compound them into products that are sold in different forms e.g., capsules, tablets, creams, and others. Pharmacies and big pharmaceutical companies use the same hormone ingredients to make their products. In other words, bioidentical hormone therapy (BHT) products custom-compounded in the pharmacy contain the same hormones found in commercially-available products. Why should women buy custom-made compounded BHT, usually more expensive, and not covered by private insurance? Compounding pharmacies can formulate products for women with allergies to a commercially-available product, individualize dosing and combinations of hormones, create products without binders, dyes, or preservatives, and compound medications with different routes of administration. However, women must be cautious with custom-made, unregulated BHT. I will discuss issues of safety in another blog; in this blog I want to bring awareness about how the same hormone can have very different effects depending on the route of administration. The route of administration is the way the drug is delivered to the body, e.g., by mouth, by injection, intravenously, or topically (cream, ointments or gels).

Mortar and pestle

For compounding bioidentical hormone products

Women with an intact uterus who are taking systemic (tablets, patches, or gels) estrogen therapy for menopause symptoms must also take a progestogen (natural progesterone or a synthetic progestin) to prevent overgrowth of the lining of the uterus (endometrium). Overgrowth of the endometrium- endometrial hyperplasia- may lead to uterine cancer. The estrogen acts like a fertilizer and thickens the endometrium and the progesterone is the lawn mower, it must be taken to prevent endometrial overgrowth. The most commonly prescribed progestogen is progesterone, the brand name is Prometrium—capsules of micronized progesterone.  It is government-approved and sold by prescription only. In order for Prometrium to be approved by FDA and Health Canada, the pharmaceutical company that developed this product had to present data from randomized control trials showing that this formulation—capsules of micronized progesterone—was used in the trials, and data obtained supports the evidence that micronized progesterone taken by mouth prevents endometrial growth. We should not extrapolate the results of the trials done with capsules of micronized progesterone to progesterone used topically—applied to the skin. Data on progesterone applied to the skin is scarce and there’s no good evidence that progesterone used this way is effective at preventing endometrial overgrowth, and potentially cancer, in women also taking systemic estrogen. Hence, if a woman with an intact uterus takes estrogen therapy and uses progesterone cream she may not be protecting her endometrium from overgrowth—the amount of progesterone absorbed through the skin may not be sufficient to “mow the lawn” and the endometrium may grow unchecked with a resulting increase in the risk of uterine cancer. This is one example of how the same hormone, progesterone, manufactured into capsules by pharmaceutical companies and into unapproved creams, can act differently, and have very different health outcomes, depending on the route of administration. Bioidentical hormone therapy (BHT) employs the same hormones e.g., estradiol, estriol, estrone, and progesterone, whether it is compounded in a community pharmacy or a big pharmaceutical company. Women have choices:  they can buy commercialized or custom-made products but they should educate themselves—learn from reputable, science- and evidence-based, reliable resources—before choosing a product. Women should question BH compounders about the ingredients used in the products and demand proof of efficacy and safety of BHT. Being informed about bioidentical therapy may be the difference between developing uterine cancer and not… Be informed, be safe! Want to know more about bioidenticals or hormone therapy in general? Contact me.

 

The second blog of this series Bioidentical-Be informed! is

2. BioIdentical Hormones – Be Informed! Part 2: Biodentical Hormone Therapy is natural, therefore bioidentical therapy is safe. Is it?

and the third blog in the series is

3. BioIdentical Hormones – Be Informed! Part 3:  HT is made from plants or herbs, like yams, soy, or chasteberry. Bioidentical hormone therapy doesn’t contain drugs. Does it?

 

 

 

Teresa Isabel Dias BSc Pharm, RPh, NCMP Pharmacist and Certified Menopause Practitioner

Visit my website www.menopausED.org to learn more about menopause and book a consultation

Follow me on Facebook  https://www.facebook.com/menopaused

Learn more about the work  I do www.linkedin.com/in/teresaismenopaused/ @MenopausEDTID

MenopausED was founded by Teresa Isabel Dias, pharmacist and certified menopause practitioner, to help women experiencing menopause challenges.

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The Menopausal Vagina Dialogue. Menopause and sex.

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What does menopause do to your vagina? Your sex life? Your intimacy? Your relationship? Your quality of life?

If you’re over 50 and sexually active you KNOW that sex feels different now compared to 10-15 years ago.
It’s usually because estrogen (and other sex steroids) decline (check with your MD to rule out other possible causes).
Estrogen acts on several tissues and organs in the female body, including the vagina; when it declines during the menopause transition women experience physiological changes that affect sex enjoyment.

Women may notice lack of lubrication, decreased arousal, and difficulty achieving orgasm; penetration may cause pain due to reduced elasticity of the tissues and narrowing of the vagina, and bleeding sometimes occurs because the lining of the vagina has become thinner and more friable. Women that are not sexually active may experience changes as well: vaginal dryness, discharge, and itching. This cluster of symptoms is called vulvovaginal atrophy (VVA), and if accompanied by bladder symptoms like incontinence (read my blog from August 2016 for more information on incontinence) and urinary tract infections, it’s included in the genitourinary syndrome of menopause (GSM). Unlike hot flashes, the most common and best-known symptoms of menopause, that improve with time, vulvovaginal atrophy worsens with time.

If you ever said or thought something like this…
“I go to bed before my husband and pretend I’m asleep when he lies down beside me, to avoid intimacy”.
“My private parts feel so raw during sex it overpowers all the pleasure I could be having”.
“I don’t want sex because it hurts. But then I feel guilty for depriving my partner of it. So I give in to my ‘duty’, and spend the time hoping it will be over soon. I feel no romance, pleasure, or intimacy during the act”.
…you’re most likely experiencing VVA. And you’re not alone: millions of women experience similar symptoms. In fact, GSM affects 50% of women, at least, and many don’t even know these symptoms are related to hormonal changes around menopause.

Vaginal discomfort affects a woman’s sexuality and self-esteem, upsets the relationship with her partner, and decreases intimacy, sexual desire, and quality of life.

In a survey of over 8,000 men and women from several countries, 69% of women and 76% of men reported avoiding intimacy due to symptoms of VVA. That’s a lot of people!

Most women suffer in silence and don’t seek help because they believe there’s nothing that can be done.

Talking about genital problems and sex is still taboo for many women and in many physician’s offices. During a visit women assume or expect their doctor will bring up the subject, and the doctor expects the women to ask for help if she has a concern with her vagina. Most women are embarrassed and uncomfortable discussing the problem and some clinicians don’t think VVA is a critical symptom that should be evaluated. Statistics show that only a small percentage of women affected by GSM get treatment and only about 7% are on any prescription.
Since treatment must be individualized, ask me or your physician what treatments are appropriate for you. Here are some choices:

Non-hormone treatments:

  • Over-the counter moisturizers applied a few times a week to increase moisture, and lubricants applied during sex may improve comfort but don’t resolve the problem.
  • Regular sexual stimulation,
  • Vaginal dilators and
  • Pelvic floor exercises provided by a specialist.

Hormone treatments:

Several vaginally-applied therapies are available, but if you also suffer from hot flashes then oral therapy may be more helpful for you.

If vaginal therapy is recommended for you do not be put off by the warnings and precautions on the accompanying product insert. If you use low dose vaginal therapies the systemic (affecting the whole body) absorption of the estrogen is very small, much smaller than if you were taking an oral pill, for example; we presume that the adverse effects are less too. But, for many reasons, the information in these low dose vaginal products doesn’t reflect that difference and lists the same warnings and precaution as for the oral products. It doesn’t make sense; we believe it doesn’t reflect the scientific knowledge we have about these therapies, hence many groups advocating for women’s health are trying to get the FDA and the manufacturers to change the information in these pamphlets.
To complicate matters a little more I must say that some available vaginal products, if used as recommended by the manufacturer, aren’t considered low dose, therefore it is very important that you be properly informed about the different vaginal therapies available and choose the most indicated for you.

If you have doubts, questions, or want to learn more about vaginal health visit my website.

Teresa Isabel Dias

BSc Pharm, RPh, NCMP
Pharmacist and Certified Menopause Practitioner

Visit my website www.menopausED.org to learn more about menopause and book a consultation

Follow me on Facebook  https://www.facebook.com/menopaused

Learn more about the work  I do www.linkedin.com/in/teresaismenopaused/

@MenopausEDTID

Menopause: More Than Hot Flashes…

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Menopause: More Than Hot Flashes…

Menopause marks the end of reproduction, is defined as 12 consecutive months without menstruation, and the best-known symptom of menopause are hot flashes. Hot flashes that happen at night accompanied by sweating are called night sweats. They tend to disrupt sleep and may start during perimenopause. Women who don’t get enough sleep may have problems with mood, concentration, memory, and performance.

But women going through the menopause transition can experience many other symptoms besides hot flashes!

The time leading up to menopause is called perimenopause and many women may start experiencing symptoms as early as 40 years of age. Hormone levels change and affect the menstrual cycles, some becoming shorter, others longer. Bleeding may become lighter or heavier, and some women may experience spotting, which is bleeding between periods.

During perimenopause hormone fluctuations may cause mood swings, with some women experiencing a rollercoaster of emotions, feeling happy and blue within hours, or having crying spells apparently without cause. These feelings may wreak havoc on relationships and it’s important that friends, partners, and family members know and understand what women go through in order to provide support and understanding, both of which are much needed at this time in a women’s life.

Fluctuating or low hormone levels may also affect bladder function. Some women may experience urgency (a sudden, compelling urge to urinate) or leakage, the inability to hold urine in the bladder because voluntary control over the urinary sphincter is either lost or weakened.

Other common symptoms of menopause are bloating and alternate constipation or diarrhea in addition to nausea and/or gas.

The tissues of the vagina are sensitive to estrogen, and after menopause, when the levels of estrogen drop, women may experience vaginal dryness and pain during intercourse. Some women may also experience itching and burning. Low levels of estrogen have a drying effect on other organs such as the skin, mouth, and eyes. The skin loses elasticity and wrinkles become more prominent. Some women get itchy skin and nails also become drier. Hair may become brittle and start to fall out.

menopause more than hotflashes

Stiffness and joint pain are reported by women during the menopause transition

Around menopause women may complain more of aching joints, especially in the hands, which can be linked to lower estrogen levels. Some women also experience soreness in muscles and even headaches.

Some of these symptoms may also be cause by medical conditions; it is important that you consult your physician to know more about your health.

For more information on menopause symptoms contact me.

Teresa Isabel Dias

BSc Pharm, RPh, NCMP
Pharmacist and Certified Menopause Practitioner

Visit my website www.menopausED.org to learn more about menopause and book a consultation

Follow me on Facebook  https://www.facebook.com/menopaused

Learn more about the work  I do www.linkedin.com/in/teresaismenopaused/

@MenopausEDTID

 

Menopause And Sex

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Menopause And Sex. Don’t let menopause ruin your intimacy!

Decrease in estrogen during menopause changes the tissues of the vagina and can cause painful sex. These changes can cause dryness, burning, irritation, discomfort, and painful intercourse.  The term used to describe these symptoms was VVA-Vulvovaginal Atrophy.

Because vulvovaginal atrophy (VVA) isn’t a media-friendly term this cluster of symptoms that affect a women during the menopause transition has been changed to Genitourinary Syndrome of Menopause (GSM).

This term is also more encompassing, as it describes not only vulvovaginal symptoms but also recurrent urinary tract infections, urinary urgency (a sudden compelling urge to urinate), and painful or difficult urination.

Also, the new nomenclature, GSM, doesn’t imply that the condition is a disease, like atrophy seems to, but it better describes a cluster of signs and symptoms linked to decreased estrogen and other sex hormones affecting female genitalia.

menopause and sex

Decrease in estrogen can cause genitourinary syndrome of menopause (GSM) and painful sex

About half of postmenopausal women experience GSM.  Even though the incidence is so high, GSM isn’t a subject women talk about freely with their friends or even their physicians. GSM is under-reported and unfortunately for many women, under-treated. GSM affects women’s quality of life because of the negative effect on sexual function, enjoyment of sex, sexual intimacy, self-esteem, and emotional well-being.

Don’t let GSM dictate your washroom breaks, ruin your intimate relationships or decrease your enjoyment of life.  There’s an array of treatments out there and no need to suffer!

There are over-the counter (without prescription) products to alleviate vaginal dryness, burning, irritation, and painful intercourse. If these treatments aren’t effective, women can use prescription topical hormone therapy, a cream or vaginal ovule inserted directly into the vagina which does not have the same side/adverse effects as hormone therapy taken orally (in a pill form).

(I will write more about hormone therapy and side effects in another post!).

Some women may also experience structural problems, such as organ prolapse*, for which there are treatments available as well.

If your physician doesn’t ask about the health of your vagina and you are experiencing genitourinary symptoms, bring it up at your next visit.

Don’t let GSM decrease your enjoyment of life!

For more information on GSM contact me. If menopause is affecting your sex life and intimacy we should talk-make an appointment

Teresa Isabel Dias

BSc Pharm, RPh, NCMP
Pharmacist and Certified Menopause Practitioner

Visit my website www.menopausED.org to learn more about menopause and book a consultation

Follow me on Facebook  https://www.facebook.com/menopaused

Learn more about the work  I do www.linkedin.com/in/teresaismenopaused/

@MenopausEDTID

 

Contraception For Midlife Women. Perimenopause.

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Contraception For Midlife Women. Perimenopause.

Contraception is important during perimenopause, the time leading up to menopause, if pregnancy is to be avoided in midlife. During perimenopause  it’s harder to predict ovulation, women may have irregular menstrual cycles  shorter or longer), and if sexually active they may become pregnant.

Women who do not desire pregnancy should use contraception until menopause, which  is confirmed after 12 months with no menstrual periods.

Contraception in midlife women

Combined oral contraceptive

Because age is a risk factor for cardiovascular disease and venous thromboembolism (blood clots), birth control containing estrogen, “The Pill”, should be used with caution in women with other risk factors like obesity, smoking, diabetes, high blood pressure, and migraine headaches. For these reasons some women may be prescribed progesterone-only contraceptives.

Intramuscular injection and oral tablets are available in Canada under the brand names Depo-Provera and Micronor respectively.

According to The North American Menopause Society, “intrauterine contraceptives offer safe, highly-effective, convenient, and long-term contraception”. There are two types of Intrauterine Device (IUD), copper (hormone free, sold in Canada under the brands Mona Lisa and Liberte ) which may increase menstrual bleeding or menstrual cramping and the levonorgestrel-releasing intrauterine system ( Mirena and Jaydess, and others brands are available in Canada).

The hormonal IUD is a particularly suitable method of contraception for women with heavy menstrual bleeding since it causes uterine bleeding to decrease and even stop over time.

Some women may opt for non-hormonal methods of birth control like condoms and diaphragms which are less effective than hormonal methods of contraception but also have fewer adverse effects.

And if all else fails there’s emergency contraception (EC) available over-the-counter without a prescription, (in all provinces of Canada, except Quebec). The best-known brand is Plan B and may be taken up to 72 hours after unprotected sex although the effectiveness decreases with time. The most effective form of EC is a copper IUD inserted within 120 hours of unprotected intercourse.

Teresa Isabel Dias

BSc Pharm, RPh, NCMP
Pharmacist and Certified Menopause Practitioner

Visit my website www.menopausED.org to learn more about menopause and book a consultation.

Follow me on Facebook  https://www.facebook.com/menopaused

Learn more about the work  I do www.linkedin.com/in/teresaismenopaused/

@MenopausEDTID

HPV Immunization In Menopause

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HPV immunization in menopause?  Yes!  I am a firm believer that prevention is better than treatment. So obviously that makes me a believer in vaccination to prevent disease.

Vaccinations seem to be a hot topic in the media these days. There’s the “victimization” of the M-M-R vaccine that prevents measles, mumps and rubella and has been wrongly associated with autism, and last week there was a lot of print in Canadian newspapers about the HPV vaccine.

I will focus on the latter since HPV immunization in menopause is something that menopausal women should know more about.

Various types of HPV can lead to different infections. Some infect the skin on the hands and feet while others target the anogenital area. Throat cancer can also be caused by HPV infection.

Human Papillomavirus (HPV) is the most common sexually-transmitted infection (STI) in Canada and elsewhere. There are many types of HPV and about 13 of those can cause cervical cancer. Even more astonishing is the fact that 80% of sexually-active people may be infected but don’t even know it. That’s because symptoms may not be felt, or may take weeks, months, or even years to develop.

The most common symptom that women experience is cervical warts. Some 70-90% of infections are cleared by the immune system but some, if untreated, can cause changes in the cervical cells and lead to cancer.

In Canada the vaccine Gardasil is indicated for girls and women 9 through 45 years of age for the prevention of infection caused by HPV types 6, 11, 16, and 18, and the diseases associated with these types:

  • cervical, vulvar, and vaginal cancer caused by HPV types 16 and 18
  • genital warts caused by HPV types 6, 11, 16, and 18
  • and other precancerous lesions.

It’s easy to see why we should vaccinate young women, before they get sexually active and contract the virus, but why should women get HPV immunization in menopause as well?

According to the North American Menopause Society, “A study released early in 2013 of women 35 to 60 years old found that HPV in women at or after menopause may represent an infection acquired years ago. Think of it like chickenpox—that virus can lie dormant in the bodies of people who were infected as children, then come raging back as shingles later in life when the immune system weakens. It’s the same with HPV. The reactivation risk may increase around age 50. This is dangerous because of HPV’s link to head and neck, cervical, vulvar, vaginal, penile and anal cancer. It is the most common sexually transmitted disease in the US. Women who started having sex during and after the sexual revolution of the 1960s and 1970s have a significantly higher risk of HPV infection compared to women who did so before 1965. This is because the risk of HPV is related to the number of sexual partners women have. Baby boomer women, and all women who have had multiple partners, should not stray too far from their Pap smear or HPV test at menopause until we know more about the increased risk of HPV flare up at menopause.”

Even if you have already been infected with HPV you should still get the vaccine. That’s because, according to Health Canada, “If you are infected with one type of HPV you can still benefit from the HPV vaccine. It can protect you against other strains of the virus. Unfortunately, even if you are vaccinated, you are still at risk for some types of HPV not covered by the vaccine. It is important that women who receive the vaccine still have regular Pap tests and practice safer sex.”

Minimizing your risk of infection includes getting vaccinated, regardless of your age, and learning about and practicing safe sex methods, which includes using a condom correctly and consistently. See your doctor regularly for a Pap test, even if you have been vaccinated.

Prevention is the best remedy…..

Helping women thrive through every stage of menopause

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