Not everything Symptoms of perimenopauseMenopause, the years leading up to menopause, are as commonly discussed as hot flashes and night sweats, for example. What may surprise you is that your vulva starts to look or feel different – in color, shape or even size.
Labia changes are just one of the symptoms of what is known as genitourinary syndrome of menopause, or GSM. Deidra Bashir, MDsays associate professor of internal medicine and medical director of the Women’s Health Clinic at the University of Kentucky Health Care. GSM is a new termfirst introduced in 2014, describes a cluster of vulvovaginal, sexual, and urinary tract symptoms that can occur when estrogen levels begin to decline in perimenopause.
When (and how quickly) these hormonal changes occur varies from person to person. The average age of menopause (which represents one year without a period) is 52 in the United States, but perimenopause can begin as early as a decade.
GSM often comes with it, affecting many people 27% to 84% of menopausal women. However, Dr. Bashir says many don’t discuss symptoms with their doctors, they just discuss them 7% of women And they are receiving treatment. In the absence of care, GSM usually does not go away, but rather tends to become worse. Karen E. Adams, MDan obstetrician-gynecologist in the Gynecology Clinic at Stanford Health Care and director of the Stanford Menopause and Healthy Aging Program, tells SELF. Read on to learn more about the condition and solutions that can reduce or even reverse symptoms.
How does genitourinary syndrome of menopause affect the vulva?
“The vagina loves estrogen,” says Dr. Adams. Although plentiful, this hormone keeps your inner canal as well as your surrounding vulva (which includes your labia majora and labia minora) healthy and moist. Once perimenopause arrives and estrogen begins to decline, “the vulvovaginal tissues become more fragile and susceptible to tearing, thinning, and dryness.” Angela Markman, MD.Obstetrician and Gynecologist in Women’s Health Specialists at CentraStatepart of Atlantic Health System, tells SELF.
Over time, the tissues lose their fullness and elasticity. “If you look under a microscope at cross-sections of vaginal tissue from premenopausal women and postmenopausal women, you can see that postmenopausal women have much fewer cell layers,” says Dr. Adams. This is what causes the contraction that you may notice in the vulva. The labia minora, or the inner lips of the vulva, may also begin to blend together or become pale in color, says Dr. Markman. The clitoral hood (a small patch of skin that protects the clitoris) can also become smaller.
