Helpline Q & A

Many older women don’t have regular vaginal examinations, but this is important for a woman’s health throughout her whole life. Nurse Continence Specialist Janie Thompson, Clinical Services Manager, leads the National Continence Helpline on 1800 33 00 66 and addresses this important issue.

WHY DON’T OLDER WOMEN HAVE REGULAR VAGINAL EXAMINATIONS?

After a woman no longer needs to have pap smears, there is often less opportunity to have a vaginal examination. "I have found when older women have a continence assessment, they are often very pleased and even relieved to have a vaginal examination," says Janie. "They may have concerns about a possible prolapse, discharge from the vagina, odour and skin issues. They may not have felt comfortable mentioning this to their GP, particularly if the GP is male," she says.

WHY IT IS IMPORTANT FOR AN OLDER WOMAN TO HAVE A VAGINAL EXAMINATION?

With menopause, there is a change in hormone levels. Oestrogen, the sex hormone needed for the female reproductive system, decreases, which can cause the tissues of the vulva, the outer part of the female genital area which includes the labia, clitoris and opening of the vagina, and the lining of the vagina to become thinner and drier. This can make sexual intercourse difficult and painful.

All our muscles can become thinner and, therefore weaker, as we age. This includes the pelvic floor muscles. These muscles are important for bladder and bowel control as well as supporting the vagina and rectal (lower part of the bowel) areas to reduce the risk of prolapse.

Due to these changes, it is important to have regular check-ups of the vagina, vulva and pelvic floor muscles, particularly if a woman has any concerns.

You are never too old to have a vaginal exam.

WHAT WILL BE CHECKED DURING A VAGINAL EXAMINATION?

During a vaginal examination, the skin and tissues around the vagina and vulva are looked at for changes, rashes, odour and any discharge. Any problems can generally be treated and sometimes a dermatologist who specialises in this area may be worthwhile seeing. Skin and tissue problems can be very uncomfortable and get worse if not treated properly.

Checking for pelvic organ prolapse (POP) is also important. Prolapses can be uncomfortable, may affect your bladder and bowel control, and how well you empty your bladder or bowel. There are different types of prolapses, so it is helpful to understand the type and size of prolapse you have.

Pelvic floor muscles can also be checked during a vaginal examination. It is important to know how to squeeze or contract your pelvic floor muscles correctly. A vaginal examination can be a useful way to check this. Working with the strength and stamina (how long you can squeeze for) of your pelvic floor muscles can be helpful for controlling your bladder and bowel.

If you are an older woman, please ask to have a vaginal examination if you have any concerns. Try to find a GP or health professional, such as a pelvic floor physiotherapist, nurse continence specialist, urogynaecologist or gynaecologist, that you are comfortable with.

For confidential information and advice, you can phone the National Continence Helpline on 1800 33 00 66 (Monday to Friday, 8 am to 8 pm AEST) and talk to a Nurse Continence Specialist.

Get Support 

Phone the free National Continence Helpline 1800 33 00 66 to speak to a nurse continence specialist about bladder and bowel health. 

This story was first published in Bridge Magazine. Subscribe and receive Bridge straight to your inbox.