"In my case, it's post-sex infections rather than dehydration - every time we have sex I end up with a vaginal infection, (which is) sometimes accompanied by urinary tract infection. I tried everything I could think of, but all my efforts failed. My partner is extremely frustrated. See, before menopause I used to be a sex goddess, and now sex has become this dreaded, almost impossible task. Is this what my life is going to be like, from now on?"

 This comment is more common than you would think. Menopausal related vaginal changes are often a source of frustration to women. Particularly regarding/when it comes to sex. It's simply one of those things that happen at a certain age without advanced warning. So when we are faced with 'it', along with Menopause, we are at a disadvantage. We are ill equipped to deal with it. And wehave to find a solution, otherwise we might choose to avoid sex altogether in order to avoid (the consequential) pain. And that's just wrong/sad/ too bad.

Menopausal/Post Menopause women are more susceptible to vaginal and urinary tract infections.

Multiple studies show that post-menopausal women are more susceptible to vaginal and urinary tract infections. Some of them try out different medicinal(?) solutions, only to discover that rather than solve the predicament, it was aggravated. Many despair, thinking the situation is unsolvable.

Which is precisely the reason for writing this article, to spread some hope around and explain this vicious cycle of infections is not a predestination. And also, to help you understandwhy it happens, and what it has to do with Estrogen decrease, to help you choose atreatment?product that actually helps, and most importantly – to help as many women as possible/you enjoy pain free intimacy and sex.

Full disclosure – I am not a physician. The information set forth is based on medical studies, publications and research as well as interviews with various gynecologists. A cornucopia of accumulated data upon which we developed Secret de Joie. My mission is to shed some light on this hushed condition, provide useful information that will enable you to make an informed decision regarding treatment, rather than change a physician/bounce from one physician to another.

Why are we more susceptible to vaginal and urinary tract infections, post menopause?

Let's start with the dry definition of vaginal dryness, as recently presented in an article on YNET by Professor Amnon Brzezinski: "Vaginal dryness is the popular name of Genitourinary Syndrome (GSM), which is characterized by a cluster of symptoms. Main symptoms include Vaginal dryness, tingling, itching, pain during intercourse, a vaginal burning sensation and frequency and urgency of urination. "

Does that make sense to you? It makes very little sense to me.

I mean, what is the connection between a feeling of vaginal dryness, itching and tingling and the frequency and urgency of urination?

Examining this "medical syndrome" closely provides a more plausible explanation: There are two different phenomena bound together in this definition. Both occur due to the decrease in estrogen, and both may encourage infections through various mechanisms.

While one phenomenon affects the moisture in the vagina while the other phenomenon affects the connective tissue and causes the bladder or uterus to sag and the treatment should be accordingly.

This is the first important emphasis of this article:

In order to solve a problem we need to treat its source, rather than its symptoms, and in menopause the source of the problem can be quite confusing. For us and doctors alike.

Estrogen receptors can be found not only in the uterus and vagina but also in the skeletal system in the cardiovascular system in connective tissue and other locations. This means that the decrease in estrogen may produce different and strange effects in any of these systems. The literature records over 40 phenomena, some stranger than others, related to menopause. Each related/connected/originates to/in a different system.

So when encountering a menopause related condition/problem, it is important to establish its source so we can treat it directly rather than settle for treating the symptoms.

While the two phenomena can cause infections and should be treated – they should be treated differently.

If you are looking for a long-lasting, viable solution to your condition, this should be your starting point: Establishing whether the condition stems from vaginal changes or prolapse of the bladder uterus, or both. This way, you will be able to make a truly informed decision regarding treatment. 

What does Estrogen decrease have to do with vaginal infections?

Our vagina has a fascinating balance system, which changes with the decrease in estrogen.

There is a symbiosis between lactobacillus, the "good bacterium" and the natural moisture that nourishes it.

In return for nourishment, the lactobacillus secretes lactic acid which maintains an acidity level between 3.8 and 4.5, which does not allow the existence of bad bacteria.

 And so the lactobacillus protects the vagina from infections.

When the vaginal moisture level decreases, our lactobacillus has less nourishment, therefore its population decreases resulting in less lactic acid. With our defense mechanism impaired, vaginal acidity level rises above 5, which serves as an open invitation for bad bacteria.

Once there are more "bad bacteria" they have the potential to cause both vaginal and bladder infections.

Which brings us to the second emphasis of this article: particularly after menopause, it is essential to maintain an appropriate level of vaginal acidity, below 4.5.

Paying attention to vaginal acidity level under 4.5 is the key to infection reduction

Protecting our vagina from Infections begins with maintaining a natural pre-menopausal level of acidity, which, as you know by now, strengthens the natural defense system against infections.

It is important to make sure that any substance you apply or insert to the vagina is at the appropriate level of acidity, since in such a sensitive situation, any product with acidity level over 4.5 may disrupt the delicate balance of the area.

The acidity level of semen, for example, is between 7 and 8, and can therefore interfere with natural vaginal pH.

The acidity level of coconut oil is between 5 and 7,  so using coconut oil as an intimate moisturizer can also disrupt pH balance and cause infections.

That isnot a recommendation to refrain from sex – far from it. That said, regularly re-balancing the pH level after sex is an excellent practice.

So it's advisable to keep vaginal pH level under 4.5, preferably by regular use of intimate moisturizer, in order to strengthen the vaginal defense system.

Which other risk factors should we watch out for? What else could upset vaginal pH balance and cause infections?

Anything with an acidity level above 4.5, which is inserted to our vagina can upset the area and cause infections.

There are two specific categories you should be aware of:

Intimate Rinsing –it is advised to avoid regular intimate rinsing at this stage in life since it could wash away the good bacteria along with the bad, impairing vaginal defense mechanism.

Lubricants - should be carefully picked, since they too can interfere with our lactobacillus and expose the area to infections.

And what about bladder infections and vaginal infections as a result of uterine or bladder prolapse?

Prolapse of the uterus, bladder and weakening of the pelvic floor muscles can lead to partial emptying of the bladder which can cause inflammation. In this condition the pH rise of the area and the weakening of the natural defense system may work together to cause infections and inflammation of the bladder.

The condition of drooping organs in the small pelvis is a condition that requires medical attention. On the other hand, maintaining the pelvic floor and its muscles is a whole issue in itself. Worth trying yoga. Pilates. Pelvic floor physiotherapy. Kegel exercises. If you suffer from sagging of the small pelvic organs, all of these can improve the condition and it is worth checking them out before the condition aggravates to a point where only surgery can help.

That said, when prolapse causes/creates stress and increases the risk of infections it is even more important to maintain the proper level of acidity to help the body's natural defense system do the work and protect against infections.

The key to strengthening the natural defense system - an intimate care/grooming routine that maintains moisture and optimal pH

The post-estrogen decline period is actually a new phase in life. What we know about ourselves may change, which doesn't mean we should return to previous estrogen levels artificially, but rather that it is a great opportunity to examine what is best for us now, and what feels good.

Just as we are introducing new grooming routines to the skin of the body and face, it is worth considering a new grooming routine for the intimate area. One that maintains a pH level that protects the vagina and bladder from infections.

After all, we deserve to feel good and enjoy sex and intimacy even in the 30 years that statistics wish us after menopause.