The Menopause Symptom That Shocked Me The Most

When I was approaching puberty, my mother barely divulged anything about menstruation — except to give me a pamphlet to read that was published by a sanitary napkin company. She left the room, and told me to ask any questions later. Of course I didn’t, as we were both too embarrassed to talk about it. Times changed when my daughter’s pediatrician told her to wear tampons so she wouldn’t miss a day of summer camp.

My mother never even mentioned menopause. If she had, I might have understood her mood swings. My daughter took required sex-ed classes in school, and one day she asked me if I “had” menopause. I asked her how she’d heard about it. “From Marge on The Simpsons,” she replied.

Although most of us have become much more open today about the hormonal changes in our female bodies, I was bewildered by my earliest symptoms of perimenopause. My male OB/GYN completely missed what was causing my itching down below. When it comes to perimenopause and menopause, hot flashes and insomnia seem easier to talk about than vaginal dryness — known medically as vaginal atrophy or genitourinary syndrome of menopause (GSM).

But it was pain during intercourse that surprised me the most.

“The earliest signs are subtle,” says Dr. Jessica Shepherd, board-certified gynecologist and menopause expert, author of "Generation M" and founder of Modern Meno. Her mission is to take the mystery out of menopause and replace it with clarity.

At first, women often notice vaginal dryness, irritation or burning, discomfort or pain during sex. Other symptoms can include urinary urgency, mild leakage, burning with urination, a watery discharge, or bleeding after intercourse.

“Without estrogen, the lining of your vagina can become thinner and less stretchy. Your vaginal canal can also narrow and shorten,” reports Cleveland Clinic.

Although we think of estrogen hormone levels decreasing in perimenopause and menopause, it can also occur as a result of certain cancer treatments, surgical removal of ovaries or during breastfeeding. A medical diagnosis should be done by your doctor, who can perform a pelvic exam, a Pap smear, and a urine test.

“Many women are surprised by how early these symptoms can show up, often in their 40s,” says Dr. Shepherd. “It’s very common, but often under-discussed.” She estimates that 50 to 70 percent of women experience symptoms related to vaginal atrophy in menopause.

WHY DOES THIS HAPPEN?