During menopause, when estrogen levels start to drop, the vaginal walls become thinner, less elastic and less lubricated. These changes can result in a number of symptoms, including vaginal dryness and dyspareunia – or pain during sexual intercourse – which is said to be one of the most bothersome vaginal symptoms of menopause. Decreased lubrication can also cause discomfort, bleeding and tearing of the vaginal tissues during intercourse.

If you're experiencing vaginal dryness or painful intercourse, I urge you to talk to your health care professional because there are treatment options available. To help prepare for that conversation, I suggest you:

• Do your homework. Educate yourself on common symptoms associated with menopause, including those affecting your vaginal health. These can include dryness, itching, burning, irritation and pain during intercourse.
• Write down your symptoms or use an online tool or smart phone app to track them. Bring those results with you to your medical visit. These results can help start the conversation.
• Make a list of all the medications you are taking, including nonprescription medicines, vitamins and supplements, and give it to your health care professional.
• If you're worried that you won't be comfortable talking about vaginal dryness or painful intercourse, use words you are comfortable with and practice what you're going to say.
• Consider what kind of treatments you would be willing to use. Treatments range from OTC lubricants and moisturizers to prescription estrogen therapy.
• Prioritize your questions and concerns in case you have limited time to talk.

If you're still uncomfortable with this discussion, during your visit you may want to:

• Hand your health care professional a list of the topics you want to discuss.
• Tell your health care professional that you aren't fully comfortable discussing the topic. This alerts him or her to approach the discussion in a sensitive manner.

During your visit, you may also want to:

• Take notes to ensure you remember key points and follow treatment recommendations.
• Ask about where you can find more information. Ask for hand-out materials or reliable websites.
• Schedule a follow-up appointment to revisit any discussion or further discuss treatment options.

Please don't feel embarrassed to talk with your health care professional about your vaginal health. Your health care professional is trained to understand the symptoms of menopause and to provide information about treatment options that will suit you.