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“The poor education we give women about their vaginal health and wellness is one of the greatest crimes in the area of women’s health,” claims Dr. Tara Allmen, of the Center for Menopause, Hormonal Disorders and Women’s Health in New York. “But it’s such an easily preventable situation. Even if you’re not sexually active, you’re entitled to a healthy vagina. A woman needs to know this information, starting when she’s in her late forties and early fifties, and entering perimenopause and menopause, because she should have a healthy vagina at 59 or 69.”

Everything changes. The cells become dainty and delicate. The vaginal PH changes, since estrogen isn’t being produced. It goes from acidic to basic, altering the ecosystem in the vagina, where organisms live, Dr. Allmen explains. Women become more prone to yeast infections and bacterial vaginosis. After 65, they have recurrent bladder infections, which can become kidney infections. And kidney infections can kill you. So vaginal health is important.

“And what do you do if you’ve met a new man, and want to renew sexual activity, but you’ve ignored or forsaken your vagina for years?” asks Dr. Allmen, whose new book, Menopause Confidential, is due out in this fall. “Sex can be impossible, painful or uncomfortable, so you need to know about products that work great.”

Local vaginal estrogen is one way to promote vaginal health and wellness, “and is the gold standard,” the doctor says. “Local stays local, although the bladder gets a little bit of that local estrogen as well. You are not associated with any risks you read about in the package inserts. What goes into the vagina stays in the vagina. Your breasts don’t see it. Your brain doesn’t see it. Your heart won’t see it.”

Local vaginal estrogen is available in pill, cream or ring form. “The majority of women, however, are still frightened of the word estrogen, ever since the Women’s Health Initiative study of 2002 warned against it,” Dr. Allmen says. “Sometimes I feel like I’m selling a used auto.”

Women with fears can instead use vaginal moisturizers, which is the second best treatment option, the doctors adds. Vaginal moisturizers from the drugstore are easy to use and are affordable. These should be distinguished from lubricants, which are designed to make things temporarily slippery during intercourse.

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