I experienced vaginal atrophy due to early menopause from breast cancer at age 37. I was too ashamed to talk to my doctor about it for more than a year.

• After I had breast cancer, I went through early menopause.
• It was harder to deal with than my unilateral mastectomy, in part because of vaginal atrophy.

After being diagnosed with breast cancer in 2017 at 37 years old, I was prescribed a targeted hormone therapy to kill the estrogen in my body, induce premature menopause, and lower my risk of recurrence. Within days, I began to experience severe insomnia, mood swings, aching joints, and worst of all, vaginal atrophy — the thinning and drying of vaginal tissue.

On many levels, I'd been prepared for the unilateral mastectomy I'd undergone as part of my treatment. However, I was completely unprepared for what my life was going to be like after menopause.

Early menopause was unlike anything I'd ever experienced

One week into the hormone therapy, it felt like I had aged 40 years. I barely recognized my body anymore. While exercising, I had to learn to set new limits for myself. My body wasn't recovering as quickly as it had before I started the treatments.

It was a difficult adjustment — one that I'm still working on — but eventually I accepted that my physical capabilities had changed with menopause. I also started taking supplements to treat my insomnia, including melatonin at night when needed. I discovered acupuncture and vitamin D helped my sore muscles and brittle bones, and I began a low-dose antidepressant to help navigate the tsunami waves of emotion I began experiencing.

After a few months, I felt like I was managing my symptoms of menopause pretty well — except for the vaginal atrophy.

It took me a while to seek help for vaginal atrophy

Before going into menopause, I'd never heard of vaginal atrophy. So when I began to experience severe vaginal dryness, irritation, and painful symptoms during sexual intercourse, I was confused. At first, I didn't realize these symptoms were caused by a lack of estrogen.

I was embarrassed to discuss what was happening to my vagina with my oncologist because I felt ashamed; I felt like there was something wrong with me. It took me over a year to finally seek help from my primary-care doctor. Finally, I made an appointment and soon found myself in tears on her examination table.

She explained what was happening to my body and that vaginal atrophy is actually a very common symptom of menopause. During that appointment, she made me realize I'm not the only person going through this.

Though vaginal atrophy is fairly common, getting the right help is less so

While a reported 50% to 60% of postmenopausal people experience vaginal atrophy, research shows only 25% of them end up seeking medical help for their symptoms. And when they do seek help, they don't always get it. Why? Because many medical professionals are not equipped to address menopausal health concerns.

I was lucky to receive compassionate care from my healthcare provider, but many in my position don't. Research shows three out of four people who seek medical help for their menopausal symptoms do not receive the care they need, in part because many providers don't receive the proper training. I wish the medical community would do more to not only help normalize vaginal atrophy so that people feel comfortable discussing these often debilitating symptoms, but also learn how to treat it.

Menopause has been discussed more openly lately, but I hope to hear more about symptoms like I experienced

Recently, there's been more public discourse about menopause, and it's no longer considered "The Silent Passage," a term Gail Sheehy coined in her iconic 1992 tome of the same name. Many public figures — including Naomi Watts, Stacy London, Oprah, and Michelle Obama — have started to talk more openly about going through it. But we don't hear as much about the more taboo symptoms of menopause, including vaginal atrophy.

I believe that many women like myself feel embarrassed to discuss their vaginal symptoms because they're ashamed to be thought of old and over-the-hill. But I know firsthand that there are very real mental-health consequences to ignoring symptoms of vaginal atrophy. Feelings of embarrassment can lead to shame and isolation and can have a huge negative impact on intimate relationships.

But no one has to go through this alone. There are many treatment options available for vaginal atrophy, and it's important to find one that works for you. I found a trusted gynecologist who helped walk me through my treatment options.

I learned that while the most widely prescribed treatments for vaginal atrophy are estrogen-filled creams, rings, and tablets, not everyone feels comfortable using products with added hormones. Even though studies have shown estrogen-enhanced products to be safe for most, the research remains somewhat confusing about the added risk of estrogen-enhanced products for cancer survivors. Therefore, many survivors remain fearful of estrogen-based products and instead are finding relief with holistic treatments like hyaluronic acid and CBD oils.

Vaginal-rejuvenation treatments like CO2 lasers and radiofrequency therapy are also gaining popularity, though most of these treatments are expensive and not covered by insurance. They also come with added risks, like the potential for infection and scarring. Those who have the financial resources are beginning to invest in these out-of-pocket procedures, even though the efficacy of these new treatments is still being studied as well. (Full disclosure: I had a pricey vagina lasering done, and while it helped alleviate irritating vaginal symptoms, it did not eliminate the painful symptoms I experienced during sexual intercourse.)

By 2025, the number of people in menopause worldwide is estimated to reach 1.1 billion. I think it's time we devote more attention to educating people about vaginal atrophy, so they're better prepared to advocate for their own health and well-being. No one should feel ashamed about the natural changes happening to their body. It's important to know you can get help.

By continuing to normalize the very common symptoms of vaginal atrophy and encouraging more open discourse between doctors and their patients, we can begin to eliminate the shame around vaginal symptoms of menopause — and help people to feel less alone.