This Little-Known Condition Affects Most Women Going Through Menopause — And Nobody Talks About It

After being diagnosed with breast cancer at age 37, I was relieved to learn that I would not need chemotherapy. Instead, I was prescribed a decade-long targeted hormone therapy program designed to kill estrogen in my body, push me into menopause, and reduce my risk of cancer recurrence.

In a sense, it was a miracle. I was alive. But in another, it was a nightmare. Within a week of starting hormone therapy, I was an insomniac, mood swings, hot flashes. Perhaps the worst side effect of menopause was extreme vaginal atrophy – that is, the thinning, drying out and inflammation of the vaginal walls – which made intercourse feel akin to to sit on a saguaro cactus.

Unfortunately, I am one of many women who have limited options when it comes to treating vaginal atrophy. While 50% of postmenopausal women experience similar symptoms, not everyone feels comfortable with the estrogen-filled creams, rings, and tablets frequently prescribed by doctors. Currently, research is confusing estrogen-fortified products and the added risk of cancer for postmenopausal cancer survivors. Some studies have shown that products fortified with estrogen are safe. However, many survivors – like me – are reluctant to use estrogen products for fear of recurrence. Although other non-estrogen vaginal rejuvenation treatments are available, most of them are expensive and risky. Women who can afford them are beginning to invest in these direct interventions, although the effectiveness of these new treatments is still unknown. Full disclosure: I had an expensive vaginal laser done, and it kind of helped me.

Until there is concrete research and medical advice widely available on the safety of estrogen-fortified products, many women will have to calculate their own risk. Right now, we feel like we have to choose between better sexual health or a lower risk of getting cancer. In terms of medical research, there is a gender gap here — as in studies of heart disease and studies of exercise science, which have historically excluded women from clinical trials. In my case, there just aren’t enough studies on the subject to definitively determine the best course of action regarding estrogen-fortified products to treat my condition.

This begs the question: why isn’t there a safe, easy and affordable solution for vaginal atrophy? There has been a treatment for erectile dysfunction since 1998, when the FDA first approved Viagra; and erectile dysfunction is basically the equivalent condition for men. Currently, most major insurance companies – including Medicare – cover the cost of Viagra or its generic form, making the drug widely available.

The Women’s Health Across the Nation study found that BIPOC women experience menopause and perimenopause earlier than white women and tend to have more intense symptoms, including vaginal atrophy. But their stories are not told. Let’s face it, women’s health issues — especially those affecting postmenopausal women — continue to be a low priority for medical research. This is as much a matter of gender equality as it is a spotlight on the fact that the vagina remains a second-rate organ. After #MeToo, you would have thought that something would change, yet the world always seems to revolve around the phallus.

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I never expected to be rushed into menopause at 37. To be honest, I’m ashamed of how little I knew. I don’t remember my mother going through menopause. The truth is, many women don’t feel comfortable discussing the physical, emotional, mental, and sexual symptoms they’re experiencing with anyone, including their doctor. Many women are embarrassed to be seen as old and overdone, given the unrealistic beauty standards of our youth-obsessed culture. The stigma against discussing menopause seems to be diminishing slightly, as public figures — like Naomi Watts, Stacy London, and even Michelle Obama — have spoken openly about menopause.

None of the treatments for vaginal atrophy, except those that may or may not cause cancer, are covered by insurance. In 2015, a drug billed as the “New Female Viagra” hit the market, after being twice rejected by the FDA. This drug claims to target female brain chemistry to increase a woman’s sexual desire. But these non-hormonal medications don’t directly treat the symptoms of vaginal atrophy and are only approved for premenopausal women.

I knew breast cancer was going to impact my breasts – and it did. But thanks to modern science, my boobs look 18 again. Unfortunately, the same cannot be said for my vagina. It is unacceptable to me that the consequence of the treatment of my life-threatening illness is also my sexual health.

Breast cancer is not a problem that all women will face, but menopause is. By 2030, more than 47 million women are expected to enter menopause each year. (It is not clear if this statistic represents the millions of cancer survivors worldwide who are pushed into early menopause during chemotherapy and/or hormone treatments.) We live in a society where there is a “pill for every disease”. If two scientists were able to discover that high blood pressure medication caused blood to rush into the penis – and caused an erection – I think we can find a way to easily and safely treat an aging (but still sexy) vagina. ).