Vaginal Atrophy – A Common Painful Condition

This condition, called vaginal atrophy, impacts 45% of women, according to a study published in the Journal of Menopausal Medicine. Because of reduced vaginal blood flow and capacity for arousal and orgasm, vaginal atrophy can interfere with your ability to have pleasure during sex, says women’s health expert Jessica Shepherd, M.D., an OB-GYN in Dallas, Texas.

After menopause, your body, specifically your vagina goes through changes.

Menopause causes your body’s level of the hormone oestrogen to decrease, and that can affect your vagina and urinary tract, explains the American College of Obstetricians and Gynaecologists (ACOG). Over time, your vaginal lining can get thinner, drier, and less elastic.

Burning, itching, spotting and painful sexual intercourse are common symptoms, as are frequent urination and urinary tract infections.

Recently, the term vaginal atrophy has been replaced with the newer term, genitourinary syndrome of menopause (GSM). This new term helps describe not just the vaginal, but also the urinary symptoms that can be accompanied by the effects of low oestrogen.

What are the symptoms of vaginal atrophy?

  • Vaginal dryness
  • Vaginal burning and itching
  • Post coital bleeding
  • Recurrent urinary tract infection
  • Frequent need to pass urine
  • Vulvar itchiness
  • Feeling of pressure in the vaginal area

The implications go beyond sex. “Vaginal atrophy can bother you even when you’re just taking a walk,” says Mary Jane Minkin, M.D., a clinical professor of obstetrics and genecology and reproductive sciences at Yale Medical School.

Who is at risk for this?

Women above the age of 50. Other factors include:

  • Smoking
  • Breastfeeding
  • Immune disorders
  • Chemotherapy drugs
  • Removal of ovaries
  • Medications like Provera and Tamoxifen
  • Lack of sexual intercourse

How is vaginal atrophy diagnosed?

A few classic signs of vaginal atrophy during pelvic examination:

  • Urethral lesion
  • Sparsity of pubic hair
  • A bulge in the back of the vaginal wall
  • Narrowed vagina
  • Dryness, redness and swelling over the vagina
  • Whitish discoloration of the vagina

What are the tests that can be done to diagnose this condition?

The condition can be diagnosed with a simple physical examination by a trained professional.

However, your doctor might carry out a few lab tests to rule out other conditions as well. For example:

  • Pap smear
  • Urine culture
  • Ultrasound Pelvis
  • Serum hormone testing
  • Vaginal pH

How is vaginal atrophy treated?

The most effective treatment option is oestrogen therapy.

There are also some treatments used to treat the patients symptomatically.

  • Hormonal therapy:
    • vaginal low dose oestrogen therapy meant to treat only vaginal symptoms. They are available in forms of cream or vaginal ring.
    • systemic hormone therapy
  • Lubricants and moisturizers to add moisture and to loosen the vagina can treat dryness. This improves comfort during sex. 
  • Dilators are devices to widen (dilate) the vagina to enable you to go back to having sex. 

How can vaginal atrophy be prevented?

As age increases, a woman`s body slowly secretes less oestrogen.

This cannot be prevented. However, there are several ways to prevent vaginal atrophy from getting worse by

  • Avoiding tight fitting clothing and panty liners
  • Reducing the usage of powders, perfumes, lubricants and spermicides

Vaginal atrophy can affect the quality of a women`s life. Please visit your doctor to seek treatment as you can prevent it from getting worse.

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