SA women hesitant to discuss vaginal discomfort with their physician may be surprised to learn that 77% of men are comfortable discussing vaginal discomfort. 90% of men actually want their partner to engage them in these conversations. This according to the first SA study to report on the impact of menopause on women’s sexuality.

Dr Smith: Although up to 50% of postmenopausal women experience vaginal atrophy, only 25% seek medical help

Focussing on postmenopausal vaginal atrophy, the study found intimacy and good communication to be closely linked but stressed the importance for women to seek treatment.

Concerningly, “Although up to 50% of postmenopausal women experience vaginal atrophy, only 25% seek medical help,” said Dr Trudy Smith, specialist obstetrician gynaecologist and gynaecologist oncologist at the Donald Gordon Medical Centre.

Although similar studies have been carried out across the world, the Clarifying Vaginal Atrophy’s Impact On Sex and Relationships (CLOSER) survey conducted in SA in 2016 is the first local study of its kind. “Until now there was no data on black African women. That was really important when we were conducting the study. We needed to get that data to see how significant the problem really was.”


  • Vaginal discomfort was an obstacle for intimacy, affecting physical and emotional relationships: 68% of women avoided any form of intimacy due to their vaginal dryness.
  • Vaginal atrophy had a negative impact on the women’s sense of self and emotional wellbeing: 53% of women felt they’d lost their youth.
  • The majority of women told their partner when they first experienced vaginal discomfort: Women aged 55-60 are more likely than women aged 61-65 to have told their partner.
  • Women were more likely to discuss vaginal discomfort with their doctor: “Although if you look demographically, black African women were more likely to discuss their vaginal dryness with their pharmacist, compared to white African women,” said Dr Smith. “That might be due to access to healthcare. It’s much easier, and cheaper, to just go into your local pharmacy and talk to your pharmacist than making an appointment to see a doctor.”
  • Vaginal discomfort led to intimacy avoidance, mainly due to less satisfying and painful sex: 68% of women have avoided being intimate, while 62% of men reported their partner has avoided being intimate.
  • 50% of women feel there is not enough information on the treatments for vaginal discomfort: Only 16% of women were happy that there was enough information on not just the symptoms, but treatment too.

With 50% of postmenopausal women affected by vaginal dryness, it is crucial for doctors to initiate the discussion on the condition with their patients.


Although only 21% of the women surveyed used vaginal hormone therapy, most said it had a positive impact on their emotional and sexual relationships, and their partners also recognised the benefits.

“Oestrogen therapy may be local or systemic, but local is preferred when symptoms of menopause are limited to the vaginal area,” said Dr Smith. “Local oestrogen therapy is administered directly into the vagina and can be given as either vaginal tablets or cream.

“Only small doses of oestrogen are needed to treat vaginal symptoms of menopause, and the vaginal response to local oestrogen therapy may be long-lasting provided it’s taken as indicated.”


Vaginal tablets significantly out-performed the vaginal cream in both user-friendliness ratings and the compliance and duration of therapy results in the study. “In fact, the vast majority of women switched over to the tablets once they were aware of them,” said Dr Smith. “The predominant reason for this was the messiness. Women also expressed concerns about the correct dosing of the cream.” That said, although the tablets fared better in the study, “whether you use a cream or tablet, vaginal oestrogen in either form works.”