I’m not going to beat around the bush. (Okay, I realize that is a not-so-funny pun.)

Why not get right to the point? Menopause brings many changes, with one of the peskiest being the way your vagina feels, including itchiness, dryness, irritation (even bleeding) and trouble with intercourse.

Blame estrogen, or a lack thereof.

So many women remain silent about this; too embarrassed to bring it up to their healthcare providers. So many healthcare providers stay silent about it, too. Maybe they are embarrassed, too – or perhaps they’re unprepared, or too rushed – to bring it up to their patients. A recent study found that only half of postmenopausal women discuss their symptoms, with far fewer seeking treatment.

It’s time to be proactive.

Here’s what you need to know:

Stop using soap on the inner parts of your vulva; clean water is adequate for washing, says the North American Menopause Society, who also suggests using only white, unscented toilet paper.

  1. Wash your underwear in detergents free of dyes and/or perfumes.
  2. Avoid fabric softeners.
  3. Stay away from using lotions and perfumed products on the inner vulva.
  4. Avoid douches and/or bubble baths.

Some women opt for oral estrogen hormone therapy (HT), which can help with these symptoms, but if you’d rather not go that route, there are other choices:

Over-the-counter lubricants and moisturizers, like Replens or Vagisil.

Topical low-dose vaginal estrogen. The estrogen contained in these creams, rings or tablets is delivered directly to where it needs to go with minimal absorption to the rest of your body, so any possible side effects from taking it orally are greatly minimized. If you’ve had breast cancer, mention this to your healthcare provider; but in general, experts agree that it is a safe treatment.

Mona Lisa Touch. A new in-office procedure, this FDA-cleared laser therapy delivers fractional CO2 energy to generate new collagen to your vaginal wall. It can also be used by women who have experienced premature menopause induced by chemotherapy, or by women who have had a hysterectomy. Usually a series of three five-minute procedures spaced six weeks apart are necessary, with an annual maintenance treatment advised; many women experience favorable results after just one treatment.

Sheryl Kraft has penned hundreds of print and online articles for publications and websites, including Parade, AARP, Chicago Tribune, Family Circle, Woman's Day, Weight Watchers, Everyday Health, WebMD, HealthyWomen, CNBC and many others. Her writing reflects her deep passion and curiosity about healthy aging, nutrition, beauty, fitness, and all things wellness.