When it comes to symptoms of menopause like hot flashes, weight gain or trouble sleeping, chances are most women wouldn't hesitate to speak to their doctor. But there is another common - and equally distressing - effect of menopause that many women just keep to themselves. The Big Ow, also known as vaginal atrophy, will affect as many as two million Canadian women in the next 10 years(1) - but most are too shy or embarrassed to talk about it, even with their doctor.