During menopause, estrogen secretion decreases, which leads to thinning of the vaginal mucosa and a decrease in vaginal secretions. This results in dryness of the vaginal mucosa, loss of vaginal elasticity, and sensitivity to stimuli. Symptoms include itching, burning, sensitivity, and pain.
Thinning of the mucous membranes also occurs in the urethra. In addition, mucosal symptoms can be caused by diseases, chemotherapy treatments, and pregnancy and breastfeeding.
Mucous membrane symptoms impair a woman's quality of life, make her more susceptible to vaginal and urinary tract infections, and affect sexual function; ejaculation, arousal, sexual desire, and pain, says Marita Karppinen , a physiotherapist specializing in pelvic floor, sex therapist, and psychophysical physiotherapist. During childbearing age, the vaginal mucosa is moist, thick, and wrinkled.
Thinning of the mucous membranes in the urethra can cause stress urinary incontinence. The function of the urethra is to drain accumulated urine from the body. The urethra has sphincters that prevent urine from leaking from the bladder between urinations. The inner sphincter is innervated by sympathetic nerves, and the outer sphincter, located outside the urethra at the pelvic floor, is a voluntarily activated external sphincter. As the mucous membranes thin, urine can leak when the pressure in the abdominal cavity increases, for example when coughing, and there may be a frequent need to urinate or an urge to urinate.
Creams and oils are used to treat the vagina and vulva/pubic area, or vulva. There are hormone-free and estrogen-containing products to strengthen the vaginal mucosa. Studies have found that topical estrogen preparations provide significant relief for 80-90% of women suffering from mucosal symptoms.
Treat dry mucous membranes in the pubic area and exercise the pelvic floor muscles
In pelvic floor physiotherapy, good condition of the vaginal and pubic mucosa is the basis for the treatment of dysfunctions. I recommend daily treatment of the pubic area for symptoms of dryness of the mucous membranes. Vaicute cream, which moisturizes the mucous membranes of the pubic area, is a domestic product containing natural estrogen from red clover for daily treatment of the mucous membranes.
Pelvic floor muscle training increases blood circulation and metabolism in the area, which improves the condition of the mucous membranes. The urethra and vagina pass through the pelvic floor in the so-called urogenital triangle. The triangle contains muscles in addition to the urethral and vaginal sphincters, and these have an effect on continence and sexual pleasure.
Exercise example: Place your hand on your lower abdomen over your pubic bone, activate the anterior muscles by pulling the edges of your vagina together, suck in the vagina and urethra, and lift your clitoris towards your navel. You will feel the muscles contracting under your hand. Hold for a count of five and relax, repeat 5-10 times, 3 sets, 5 days a week for three months.
Article author Marita Karppinen
Timjame Oy / Physiotherapy Marita Karppinen
Sources:
Medical Journal 17.1.2020, 3/2020 vsk 75, p.117-121 Local estrogens and breast cancer.
Heiskanen J., Jernfors V., Parantainen A. 2020. Pelvic floor physiotherapy pp.52-75. VK-Kustannus Oy.
Sand Olav et al. 2011. Human, Physiology and Anatomy pp. 495-520. Sanoma Pro.
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