Lubrication and HRT

In my last piece I spoke about the joys of a great toy. The next thing to discuss is lubrication.
A good, organic lube is a great idea for all ages and activities, but it’s vital for menopausal women. I like organic because lubes are absorbed into the bloodstream. Water based is safe with sheets, toys and condoms, but it can soak in quickly needing several reapplications.

Oil based is thicker and lasts a lot longer and can be used as a barrier, to prevent water based lubes from soaking into the skin. Using oil based lubes under water based lubes is a technique designed by Yes Organics called the Double Slide and works wonders for dry vaginas and vulvas. Just keep a towel nearby to wipe hands and genitals so as to avoid oily sheets. If you go for oil based, it’s best to aim for nut rather than petroleum based oil as there’s less chance of irritation. Oil based lubes will weaken and break latex condoms.

Finally there’s silicone. This man made lube is very slippery and lasts well. It’s safe with condoms but not with silicone toys. Because it isn’t natural, it can cause irritation so it’s best to patch test before slathering it on. If it doesn’t irritate, it can be a great lube

As our vaginas and vulvas are extra sensitive as we age, they are more prone to irritation. So it’s always wise to avoid scented, flavoured, heating or cooling lubes. These are packed with sugars and/or chemicals that can cause irritation.

Apply lube inside the vagina for penetration, as well as on the item that’s penetrating. Aim for a wetness similar to your mouth when it’s watering. Reapply as needed because if you don’t, you may as well not bother with lube in the first place. Lube is also excellent for masturbation of self and others. There’s no pull on the skin with lube so it makes all touch more enjoyable and can make hand jobs much easier for women who worry about hurting their person’s penis.

When oestrogen levels drop significantly, it won’t matter how turned on we are, or how much lube we use, we may still find sexual touch irritating or painful. The discomfort might appear during penetration, or even while engaging in typical daily activities such as exercising, walking, or wearing certain clothes like fitted jeans.

If left untreated, the walls of the vagina can painfully fuse together creating a need for laser treatment (the good news it’s very effective). If caught early, and with the appropriate oestrogen treatment, women can recondition their vaginas so that there is no pain or discomfort, even with penetration. There should be no pain or discomfort!

Nowadays we can choose our HRT in the form of pills, patches, gels or creams. Vaginas can benefit from oestrogen pessaries that go directly to the parched vaginal tissue as needed. Vulvas and clitorises can plump up with an oestrogen cream for increased pleasure and comfort. Doses are lower as the hormones don’t have to travel through the organs to get to where they’re needed.

If you have a womb, you’ll be given progesterone in the form of an oral medication or combined patch with oestrogen. Progesterone can help with sleep as well as keeping your uterine lining in good shape. During perimenopause, hormone levels fluctuate so it’s okay to need to adjust the levels over time. If you don’t notice a significant change in symptoms, you may need to up your dose.

All menopausal symptoms should improve with the right levels of HRT so there’s no need to suffer in silence or to ignore symptoms. For some, improved sleep, less weight gain, less urinary leakage, and more energy are enough to increase libido, but if not, a tiny amount of Testosterone might be the answer. But if your relationship isn’t in great shape, or if you didn’t really enjoy sex prior to menopause, Testosterone alone won’t be enough to fix libido. That doesn’t mean you’re broken or hopeless, just that libido is a multilayered experience for most of us. One thing at a time. Get your energy back and then look into other issues as needed.

We now know that our hormone health is reliant on our gut health. So if you have digestive issues, it’s well worth getting some help so that your hormones can regulate as naturally as possible with or without HRT. There are some great gut specialists who can provide guidance, supplements and support for this.

In Ireland the majority of menopause specialists are actually GPs who have undergone specialist training. It’s important to find someone who is up to date and knowledgeable. If you feel unheard or are made to feel unreasonable, if you’re prescribed antidepressants or told to just get on with it, or if you’re told you need expensive blood tests, you’re seeing the wrong person. There are wonderful professionals who will believe and listen to you, and prescribe appropriately. You can find out about the benefits and risks of HRT here: https://www2.hse.ie/conditions/hrt/risks/