Vaginal Health in Midlife: What Every Woman Needs to Know

When was the last time you had an honest conversation about vaginal health? For many of us, the answer is never. We grew up in a time when talking about periods, menopause, or sex was considered “taboo.” But as women in midlife, we deserve better. We deserve real answers, open conversations, and permission to put ourselves first.

That’s exactly why we sat down with Dr. Erica Hope, a gynecologic oncologist, on this week’s episode of the No Expiration Date Podcast. Together, we dug into the changes that happen in perimenopause and menopause—and how they affect not just our hormones, but also our vaginal and overall gynecological health.

The Hidden Symptoms of Midlife

One of the big terms Dr. Hope introduced is GSM—Genitourinary Syndrome of Menopause. It sounds intimidating, but really it’s a blanket term for symptoms like:

• Vaginal dryness

• Pain during sex

• Burning, itching, or irritation

• Frequent urination or nighttime trips to the bathroom

Up to 50% of sexually active women in midlife experience these symptoms, yet most of us don’t talk about them—even with our doctors. Why? Because we think it’s “just part of getting older.” Dr. Hope’s message is clear: just because something is common, doesn’t mean it’s normal—or untreatable.

Screenings You Can’t Skip

Dr. Hope reminded us of the big three screenings that save lives:

• Pap smears – Quick, simple, and essential for catching precancerous changes.

• Mammograms – Starting at 40 (earlier if you have risk factors).

• Colonoscopies – Recommended by age 45, since colon cancer is showing up earlier and earlier.

These aren’t “nice to haves”—they’re non-negotiables if you want to protect your health in midlife and beyond.

Hormones, Pelvic Floors, and Painful Sex

As estrogen levels decline, so does the natural lubrication and elasticity of vaginal tissue. That’s why many women experience painful sex, low libido, or even pelvic floor dysfunction. But there are solutions:

• Over-the-counter vaginal moisturizers (daily use)

• Lubricants for intercourse (water or silicone-based)

• Vaginal estrogen (cream, pill, or ring) for long-term relief

• Pelvic floor therapy to address incontinence, prolapse, or pelvic pain

The key? Talk to your provider. Advocate for yourself. And if one doctor brushes you off, don’t be afraid to get a second opinion.

Busting Myths Around Hormone Therapy

We couldn’t have this conversation without diving into Hormone Replacement Therapy (HRT). For years, women were scared away from hormones due to outdated studies. Now, research shows that HRT can:

• Reduce hot flashes and night sweats

• Prevent bone loss and osteoporosis

• Improve vaginal health when paired with local estrogen

But not all hormone treatments are created equal. Dr. Hope gave us a word of caution about pellets—popular, but not well-regulated. Instead, she recommends FDA-approved options like patches, creams, or oral prescriptions tailored to each woman’s needs.

A Final Word from Dr. Hope

“Your voice and your vigilance are some of the most powerful tools you have in protecting your health. Don’t chalk up your symptoms to ‘just getting older.’ Trust your instincts, ask questions, and insist on answers until you feel heard.”

Why This Conversation Matters

September is Gynecologic Cancer Awareness Month, and this episode is a reminder that being proactive about our health is non-negotiable. Our moms and grandmothers didn’t always have the language—or the freedom—to talk about these issues. We do. And it’s time we use it.

Because here’s the truth: your body deserves care, your symptoms deserve attention, and your health has no expiration date.

🎧 Listen to the full episode with Dr. Erica Hope → [Insert Podbean link]

Watch full episode on YouTube → 

💬 What questions do you still have about midlife vaginal health? Drop them in the comments below or send us a message. We want to keep this conversation going.