What to expect ‘down there’ after menopause

Cathy Jones

When Cathy Jones had her daughter at age 40, the increased risk of pelvic floor issues made her pay much closer attention to what was going on down there. Now, 20 years later, the (This Hour has 22 Minutes) comedian is still focused on her lady bits, working material about menopause and even vaginal atrophy into her touring one-woman show, Stranger to Hard Work. She wants to deliver the message that, contrary to many cultural cues, there’s plenty to look forward to as a living, breathing, sexual woman in the later stages of life. She spoke with Chatelaine magazine while she was in Toronto.
 Part of the interview:
"A lot of people don’t want to talk about vaginas, but I’m right into it. I have a lot of friends who are heading into menopause — they’re looking at me, sweating from a hot flash, and they’re freaking out. I’m realizing, Oh my god! They’re coming through the portal!"
A portal to hell?
"No! One of the reasons I’m passionate about all this is it’s important to keep things going in terms of vaginal health. After menopause, the tissues of the vagina are lacking estrogen and they start to get dry and irritated. That leads people to say things like “I don’t even want to go to the doctor to get my pap smear,” because it’s painful. But it’s an incredibly important aspect of aging that I think a lot of women aren’t talking to their doctors about, and a lot of doctors aren’t talking to women about. People so often refer to “dried up older women” — it’s so insulting. The ease with which people talk about erectile dysfunction . . . nobody talks about anything that happens to women. They just sort of push them aside and move on to somebody younger so they don’t have to discuss it."
What are some misconceptions about menopause? Would you count ‘Oh, I’m just going to be dried up’ as one of them?
"It doesn’t have to be that way. Men’s testosterone goes down gradually, like that guy Sully landing that plane on the Hudson River. Finally, they’re like 116 years old and still trying to have a go at the nurse. And she’s like, “Wait til I get your catheter out!” It’s like men have always been characteristically still interested in sex in their 80s and 90s. But women don’t have to just grin and bear what happens when we get older."
So if the testosterone drop in men is like Sully’s plane landing, what’s the estrogen drop like for women? A meteor crash?
"It’s like one of those big rides at the fair where you suddenly go “Woaaah!” and are dropped down. You’re losing a lot of estrogen quickly and you’re going down hard. That’s why it’s a difficult passage for people, there’s all kinds of things going on in your mind."
Let’s talk silver linings — what’s there to look forward to?
"Sometimes you hear the saying “Every decade is better,” and you’re thinking “Wha? How’s that possible?” But it is better for me in my 60s, and I was so scared of reaching this age in my 40s. Knowing you’re not going to lose that connection of feeling aroused or healthy down there — that’s a really important thing to know. You may be changing, but you’re not losing a great deal."
How much can people expect to hear about vaginas when they come see your one-woman show?
"I want to say that when you’re talking to me, you’re talking about vaginas a lot. But seriously, just a bit. I just talk about how we shouldn’t let it go – I chastise the audience for starting to wear those funny glasses that women start wearing in their late 60s."
You mean like [22 Minutes character] Marg Delahunty wears?
"Yeah! Like plaid glasses and glasses that look like bowling ball material. Also the ones with chains hanging from the arms so they can be worn around the neck. They’re like glasses that say “Go away! There’s nothing to f–k here!” There’s no need to wear those funny glasses if you keep things going."
 And for gosh sakes don't start  dressing  like an old lady in flowery dresses and too much jewelry. Dress with style and a little pizazz and don't cut your hair into the obligatory hair helmet. Just keep it loose and casual.  Go to a spa and get a facial, manicure and pedi or just do it at home. A moderate amount of cosmetics is also good for the self image. If you still look good and sexy, you will feel good and sexy. And that is a promise.
A couple of good ways to keep things going down there:  See your doctor and find out if hormone therapy would be good for you. Also,  Estrogen vaginal cream is great for restoring dry sensitive tissue. If that tissue is healthy and plump, sexual intercourse  sounds much more interesting. Also get a pure unadulterated lubricant, without fragrances or chemicals that make you tingle. And use it every time you have intercourse so the friction does not cause inflammation or soreness.
 Get an exam to make sure your uterus is not prolapsing. This causes older women so many complications. In some serious cases of prolapsing uterus, there is relatively simple surgery. Do not delay if this is your problem. Delay can lead to dangerous and painful complications.

Pelvic prolapse: Why Kegels should be your new best friend:
That little leak when you cough is a sign that your pelvic floor needs strengthening. The muscles along the pelvic floor hold up organs like the bladder, uterus and colon, and need to be kept strong, just like other muscles in the body. If they become deconditioned, a variety of complications could occur — from organ prolapse to difficulty with bowel movements and urinary incontinence. Pelvic prolapse can be caused by pregnancies, age and good old gravity; also giving up on exercise.

Kegels — contract-and-release exercises you can do anywhere — are a good place to start. (To find the muscles, try stopping urination midstream. Those are the muscles you’re trying to engage.) Women of every age can do Kegels as a preventive exercise, and once you get the hang of them, you can do reps while you’re standing in line at the grocery store or at the bank machine. Eventually, you might be able to cough standing up without worry!

SISTER FRIENDS, It ain't over till it's over  .... and  you get to decide