Dr. Marla Shapiro, a Toronto-based physician and menopause specialist, sheds light on below-the-belt women’s health matters, including vaginal dryness, and tells us what she wishes more women would do.

Are there specific questions you always ask each patient?
“In addition to crucial general assessments—do you smoke? Do you drink alcohol?—I encourage my patients to ask me anything. Knowledge is power. The more information you have from a trusted health-care provider, the better equipped you are to take care of yourself. So ask anything and be sure to follow up if an answer was confusing or unclear.”

Do patients get nervous asking about symptoms that are totally normal?
“All the time. If you’re concerned about something, it’s better to talk to a trusted health-care professional and to find out that everything is OK, rather than to let something pass because you think it’s a silly question.”

What’s a bad habit that you commonly see in your practice?
“Due to the competing demands on them, women often don’t make themselves or their health a priority. Tell yourself, ‘It’s worth it for me to invest in my health.’ Think of the oxygen-mask analogy: On an airplane, before you can help the person next to you, you must put on your own oxygen mask first. In order to be the best mother, partner, daughter, friend, sister, coworker, you have to prioritize your well-being above all.”

How should women wash their vulva?
“Good old-fashioned soap and water, and avoid perfumed products, which can be irritating. The vagina is self-cleaning, so, for the most part, you can let it take care of itself. That said, vaginal dryness and the thinning of tissue associated with the loss of estrogen and menopause may necessitate adding some moisture back to the area by using a vaginal moisturizer.”

Should women expect some vaginal dryness as they approach menopause?
“Every woman who goes through menopause will experience progressive vaginal dryness. This lack of moisture follows a decrease in estrogen that happens during this time. Unlike some hormonal symptoms that improve over time, such as hot flashes, if left untreated, dryness will not go away and could worsen. The good news is that you can do something about it: Use a vaginal moisturizer to replenish moisture on an ongoing basis, and try a lubricant during sexual intercourse.”

What’s your best advice to women for keeping themselves healthy?
“Be aware of your body and the power that it has. Keep on top of medical appointments, ask questions and take care of yourself. Don’t smoke. Exercise, practise mindfulness and reduce stress.”