Linda Dares is an avid Rambler, newly retired mother and grandmother, and long-time Salt Spring Islander who has spent the last 35 years living in one of British Columbia’s most beautiful island communities. Born in Portage La Prairie, Manitoba, she has called many places home over the years — including Manitoba, Ontario, British Columbia, the Yukon, California, and even Germany during her childhood on Air Force bases.
At 53, menopause was well and truly behind me. The hot flashes and sweaty nights were over. No more periods. Phew! This was a great time to enjoy this stage of my life. I felt like one of the lucky ones.
And I was. But what I didn’t know yet was that some of the effects of menopause can show up much later, particularly in the parts of our bodies we are often least comfortable talking about: our vulvas, vaginas, bladders and pelvic floors.
My first surprise arrived about two years ago, when I developed an itch that simply would not go away. I assumed it was a yeast infection and treated it as such, but the itching persisted. I couldn’t really see down there, so I used my phone to take a picture and saw some spots. Because of the discoloration, I started to worry that maybe I had cancer.
I went to my doctor, who happened to be male, and I found this very embarrassing. He said I was right to be concerned and referred me to an OB-GYN. I went to see her and was diagnosed with lichen sclerosus—LS—which, despite the name, has absolutely nothing to do with moss or trees.
Lichen sclerosus is a chronic inflammatory skin condition that most commonly affects the vulva and the skin around the anus. It is particularly common in postmenopausal women and is thought to involve the immune system. The itching can be intense, but women can also experience burning, soreness, fragile skin, small tears, and painful sex.
Over time, untreated LS can cause scarring and changes to the structure of the vulva, including narrowing or fusion of tissue. There is also a small increased risk of vulvar cancer, which is one reason ongoing medical follow-up is important.
Mine is treated with a prescription steroid ointment, which helps control the inflammation and protects the tissue from further damage.
Since I had never heard of LS, I decided I should talk about it with some of my friends and other women. I felt that this needed to be discussed, and I didn’t want anyone to end up with disfigurement from this disease because they didn’t know what was happening.
So far, I personally know six women who have LS. Six!
I believe we need to be sharing this information with one another. If I know six women, how many more are struggling with this? How did I reach my late 60s without knowing this was even a thing?
Now I am 71, fit and active, so being healthy and feeling good is extremely important to me. I belong to Sole Sisters, and my daily walks and hikes are integral to my sense of well-being.
Then came the rectocele.
Why? My vagina was betraying me again. I didn’t have difficult births, so why was this happening?
A rectocele is a type of pelvic organ prolapse. The tissues supporting the pelvic organs weaken, and the rectum pushes forward into the back wall of the vagina, creating a bulge. Pelvic organ prolapse becomes more common with age and after menopause, and childbirth is one of the risk factors—but you don’t necessarily need to have had traumatic births for it to happen.
The physical sensation is difficult to describe unless you have experienced it. Imagine suddenly feeling a bulge between your legs that you know should not be there. There can be pressure, heaviness, and discomfort, and depending on the prolapse, women can have difficulty with bowel movements or feel as though something is falling out of them.
I asked my partner how on earth he could stand having testicles because I certainly wasn’t coping very well with my new crotch bulge. In fact, I was quite distressed. Walking was uncomfortable, and walking is my happy place.
There is a funny side to almost everything if you look hard enough, but there is also a psychological side to this that we don’t talk about enough. Something appearing between your legs that wasn’t there before can be unsettling. You can feel embarrassed, less confident in your body, worried about exercise, worried about sex and, frankly, a little betrayed by anatomy you have barely thought about for most of your life.
For me, the solution to the rectocele was surgery followed by six weeks of recovery, and thankfully, it went extremely well.
Problem solved. I felt very relieved.
Except then there was another bulge.
I was walking one day when I felt that sensation again. I went to see my OB-GYN, and she said nothing was wrong. But I knew something was, so I went back. This time, the bulge was more apparent. I knew it was there because I was having trouble walking comfortably.
What on earth was going on down there?
This time it was my bladder. I had developed another type of pelvic organ prolapse called a cystocele, or anterior vaginal prolapse. This happens when the tissues supporting the bladder weaken, and the bladder drops down against the front wall of the vagina. In more significant cases, that bulge can reach or protrude through the vaginal opening. Apparently, after the rectocele was repaired, there was room for the bladder to prolapse.
My gynecologist did not recommend another surgery in my particular situation, so for now I use a pessary. A pessary is a removable silicone device placed inside the vagina to support the pelvic organs—rather like scaffolding for your insides. They come in different shapes and sizes and need to be properly fitted. Some women use them temporarily, while others happily use one for years.
Mine works extremely well. Most of the time, I can get on with my life without thinking about the prolapse very much at all.
Except, of course, there is sex.
Depending on the type of pessary, intercourse may require removing it first, and mine is not particularly easy to remove. In fact, it is nearly impossible, sometimes causing me to cry with frustration. I had to find a solution for removing it, not because I was eager to have sex, but because I also wanted to be able to remove it for hygienic reasons.
I’m not sure how I eventually got the idea to try dental floss.
I tied dental floss through one of the holes in the pessary, leaving enough of a tail that I could grab onto it. Not exactly something I imagined myself doing at 71. I also ordered a pessary-removal tool—a little grabber of sorts—but so far, it and I have failed to establish a productive working relationship.
Dental floss it is.
Sex itself has changed too. The rectocele repair left the vaginal opening tighter, so intercourse can sometimes be painful. And, to be completely candid, at this stage of my life I could happily never have intercourse again. My partner, however, remains considerably more enthusiastic about the enterprise. We are finding alternative ways to feel intimate.
One other side effect of all these vagina issues is the need to pee often. As a hiker, I need to make sure I go often before a hike. Pads are now back in my life. I thought I’d seen the last of them years ago.
I’m not sure what’s next. It could be wearing Depends, but that won’t stop me from hiking.
READ MORE > Ramble Log, Rambler Cafe Blog
Please note: This blog shares one woman’s personal experience with menopause and pelvic health. It is not intended as medical advice. If you have symptoms or concerns about your own health, please speak with a qualified healthcare professional.
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