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A Gen-X heads-up: Peri-menopause

As a generation, Gen-X are DIY-ers.

We like to understand what’s happening and what to do about it, do it, and get on with life. We find knowledge both soothing and essential. And that is who I am writing this for: my Gen-x sisters. Heads up.


Here’s what happened.

Me: 47, decent+ health. No serious underlying pathologies.

I was going along in peri-menopause, irregular periods that sometimes looked weird, some skipped ones, sometimes two a month. Some hot flashes at night. Nothing too crazy. All manageable.

Then I got what seemed at first like a yeast infection. I had red, irritated labia, and a discharge that was thick and white. No foul odor though. This was unusual, but I thought that maybe my fluctuating hormones were offering up yet another new experience. I did my usual pseudo-hippie remedies that had worked before...and nothing. I thought maybe I misdiagnosed myself and it was actually bacterial vaginitis. The redness was spreading, and I was experiencing burning pain any time I wiped. Intercourse was entirely off-limits. So I tried douching with an herbal tea that had previously completely cleared up BV for me. I got a little relief for a couple of hours, and then it came back. This had been going on for a couple of weeks by now. I had been googling everything I could think of and had gone to see my health care provider. I had consulted Chinese medicine practitioners. I had tried over-the-counter and herbal remedies.

It just kept getting worse. It was starting to hurt to sit normally. The burning pain was spreading to my urethra. I found myself avoiding drinking water because the process of peeing and wiping was so uncomfortable. I wondered, could I have a yeast infection, bacterial vaginitis, and a UTI all at the same time? What was happening???

I went to my hormone doctor (I have been on DHEA and progesterone to manage peri-menopause and migraines for years). I spit in tubes and had lab readings. Everything looked pretty good.

I asked her, "Well, then what is wrong with my vagina?"

Thank goodness, she had an answer.

She told me about estriol. It is one of the three types of estrogen: estradiol, estrone, and estriol. I have listed them from most potent to least. Estriol's receptor sites are in the nipple tissue and vaginal tissue. When you don't have enough estriol, you can experience (wait for it...) vaginal atrophy. Full stop. What? Images of dried prunes danced in my head. I was too young to be atrophying anywhere!

Or maybe not. Now that I knew what to google, the hunt was on for more information. Apparently, around 30% of women experience vaginal atrophy as part of peri-menopause or menopause. It's one of the 'big 4'- hot flashes, weight gain, depression, and vaginal dryness (jeepers, what fun!). If treated early, it can be easily controlled. If not, it can cause long-lasting symptoms that never fully resolve.

I read sad stories of women who no longer have sex or ride bikes.

And I kept wondering, why didn't anyone tell me about this? Not just vaginal atrophy, but peri-menopause in general? It's like going through puberty all over again. I am fortunate enough to have women friends who are older than I am. The other day I was talking to one in her mid-70s about peri-menopause, and she said, (paraphrased) "Yeah- you finally feel like you know how to take care of yourself, then all hell breaks loose, and it will settle down- at about 52 I was better, but then old age starts creeping in." Yikes.

And while I am glad to have people to ask, I still feel like something that has a massive effect on the health and well being of 50% of the population has very little press. And so I am doing my small part by writing this blog post.

Bottom line:

If you are over 40 and have what seems like a yeast infection, BV, or a UTI but is a little different or doesn’t respond to your go-to remedy, get thee to a hormone doctor and ask about vaginal atrophy and estriol. Quick.


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