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When it comes to ageing, few body parts go through quite so much over the course of an average lifetime as the humble vagina. Changes to collagen production and hormone levels bring about natural changes from puberty through to the menopause, which can, of course, be exacerbated by sex, pregnancy, childbirth, and even certain cancer treatments. So what kind of changes can you expect, and what can you do to keep your vagina healthy throughout your life? Incontinence , or the involuntary leakage of urine, is a common issue that can affect women of all ages, but it does become more common with age.

Many women begin to notice it during pregnancy or after vaginal delivery, because of the stress childbirth places on the pelvic floor muscles and urethral sphincter. As your vagina ages, and the structure is strained by traumas like childbirth, that entrance to your wee tube goes from being round to quite long and pouty," explains urology nurse Emma Soos, the managing director of The Women's Health Clinic.

These anatomical changes can also put you at increased risk of urinary tract infections UTIs , but can often be treated with lifestyle changes. Find a range of women's health pharmacy services, delivered by local providers at a time that suits you. The vagina also changes according to fluctuating hormone levels, Soos explains. Likewise, when oestrogen levels drop - as in menopausal women - the structure changes again, and can lead to atrophy, or persistent vaginal dryness.

This coincides with a natural slowing down of collagen production, which makes the vaginal tissue less elastic, drier, and more crepey - not dissimilar to the wrinkles you get on your face as you age, Soos explains. They were increased still further by the fact I was having hormone treatment to bring my oestrogen levels from quite high down to zero," she says.

I couldn't even put the tip of my little finger a quarter of an inch inside my vagina; it was just too painful. In most cases, atrophy can be easily treated - for example, by using lubricants or vaginal moisturisers before sex. If it's not too uncomfortable, having sex or masturbating will also help to keep the area moist and supple. However, if your symptoms can't be controlled in this way, Panay explains, you may be prescribed vaginal oestrogen - a hormone treatment available in the form of pessaries, creams or vaginal rings.

The use of vaginal oestrogen in women with a history of oestrogen-positive breast cancer is a contentious issue; the American College of Obstetricians and Gynecologists recommends working with the woman's oncologist to decide if such a treatment is appropriate. The College makes the point that: "Data do not show an increased risk of cancer recurrence among women But they recommend that it be considered only in women who have failed to respond to non-hormonal treatments.

Such a procedure is not recommended by the NHS as there's not yet enough evidence to confirm its effectiveness. The laser works by creating a microinjury, which, Soos explains: "triggers a cascade of wound healing, so the body's natural wound healing mechanism kicks in. As well as reviving her sex life, Sara says her vagina feels plumper, less painfully sensitive, and her recurrent UTIs have stopped.

Finally, prolapse is a condition where one or more of the pelvic organs - such as the uterus, bladder or rectum - slip down from their normal position and bulge into the vagina. Prolapse isn't life-threatening, but can be uncomfortable and affect your quality of life. Again, it can often be improved by pelvic floor exercises and lifestyle changes - such as stopping smoking, weight loss, and exercise. If you are still suffering despite these changes, other options include vaginal pessaries to hold the vaginal structures in place, hormone replacement therapy including topical treatment or surgery.

It is important to know that as a result of serious and well-recognised safety concerns, the National Institute for Health and Care Excellence NICE updated its guidance about surgery for prolapse in December They no longer recommend that transvaginal mesh the insertion of mesh deed to provide added support after prolapse surgery and reduce the risk of recurrence should ever be used for prolapse except in specific research circumstances. Often, simply knowing what to expect helps women feel more prepared to cope with these natural changes.

Besides regularly practising your pelvic floor exercises, there are several simple steps you can take to keep your vagina healthy as you get older. Likewise, she adds: "Pubic hair offers a natural barrier to keep things clean, decrease contact with viruses and bacteria, and to protect the tender skin of the area.

Shaving your pubic hair puts you at higher risk of contracting STIs , and also irritates the hair follicles left behind. While you're still menstruating, use whichever products make you most comfortable, and remember to change tampons regularly to avoid toxic shock syndrome TSS - a rare but life-threatening bacterial infection.

Wearing cotton underwear and sleeping naked can help the area to breathe, and prevent yeast infections like thrush, while practising safe sex will protect you from STIs. Finally, Mackay says: "Attend your cervical screening appointment smear test , and don't ignore any abnormal symptoms, however embarrassing. I see so many posts on here about constant or provoked vulva pain that I thought it might be useful if I explained vulvodynia and how I cured mine. Vulvodynia literally means vulvar pain and is a Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.

Egton Medical Information Systems Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions.

For details see our conditions. Understanding vulvodynia and why it causes painful sex. Worried about your health? Find a range of women's health pharmacy services, delivered by local providers at a time that suits you Book now. Read next. Labiaplasties — what are they and are they ever medically necessary? Myths about the hymen debunked.

How to manage lichen sclerosus and genital itching. the discussion on the forums. Health Tools Feeling unwell? Assess your symptoms online with our free symptom checker. Start symptom checker. Read next Understanding vulvodynia and why it causes painful sex.

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