Vaginal atrophy is a very common condition among postmenopausal women, but it can affect women of any age. Despite its prevalence, it is still quite unknown to many and even the doctors don’t pay as much attention to this issue as they perhaps should.
What is vaginal atrophy
Vaginal atrophy is a condition that can affect women at any stage of their lives, but it is more common during menopause. According to a 2003 study, approximately 45% of postmenopausal women suffer from it, even if its importance is often downplayed.
As the estrogen levels decrease in this life-stage, it causes the thinning, drying and inflammation of the vaginal walls and muscles. This turns sexual intercourse uncomfortable and painful which leads women to avoid intimacy with their partners.
Since sex stimulates the vaginal muscles as if it was a regular workout, the absence of intercourse can worsen the condition as the unworked muscles stop being toned and become progressively thinner.
What are the symptoms
The clearest symptom of vaginal atrophy is dryness. The body does not produce enough estrogen stimulate the lubrication of the vagina, which leads it to become dry and with an itchy and burning sensation. These symptoms can make intercourse painful, uncomfortable and even lead to vaginal bleeding.
Due to the lack of fluids in the vulva to keep the good bacteria healthy and to fight infections, vaginal atrophy also results in frequent urinary tract infections, an increased urgency with urination and a burning sensation when at it.
These urinary symptoms are quite common and one of the reasons this condition is disregarded often as doctors focus only on treating these as isolated symptoms.
Vaginal atrophy is caused by a decrease in the estrogen levels. This reduction is natural during menopause and in the period that precedes it (perimenopause) and in the case of surgical menopause, when both ovaries are removed.
Chemotherapy is also a common cause as well as radiotherapy directed at the pelvic area.
Can vaginal atrophy be reversed?
It depends on the causes. If the decrease of estrogen levels is due to menopause, the symptoms can be soothed and controlled but it is unlikely that everything will be as it was before. A treatment using estrogen can help to balance the hormonal levels, but you will need to readjust them with time as the body’s production keeps decreasing.
Vaginal atrophy can also be temporary in the cases of hormonal imbalances caused by other factors. Pregnant or breastfeeding women, for instance, might experience it for a time but as the hormones become balanced again the symptoms will likely revert completely too.
When to see a doctor
You only need to see a doctor if the symptoms affect your lifestyle. If sexual intercourse becomes painful, if you feel discomfort and itchiness even with the use of vaginal moisturizers or if you get a urinary infection.
The condition itself doesn’t require treatment, but you don’t need to live and endure its symptoms either.
The treatment for vaginal atrophy will depend on the severity of the symptoms.
During the perimenopause phase, dryness and discomfort during sexual intercourse are the main symptoms. These can be soothed with over-the-counter vaginal moisturizers that you can apply several times a day to reduce the distress or water-based lubricants for sex.
If none of this help, then you might require a prescribed estrogen treatment.
In these treatments, the estrogen is absorbed through the skin, which limits the quantities that enter the bloodstream.
Vaginal estrogen ring: a soft and flexible ring is inserted in the upper part of the vagina and releases consistent doses of estrogen. It needs to be replaced every three months.
Vaginal cream: The cream is inserted in the vagina using an applicator and it offers fast relief of the symptoms. Your doctor will tell you which cream to use and with which frequency.
Vaginal estrogen tablet: similar to the vaginal cream, but less messy. The tablet is inserted into the vagina using a disposable applicator and your doctor will tell you which tablets to use and the frequency of their application.
Oral estrogen is usually the last resource. It can be used to treat hot flashes and vaginal dryness during menopause, but it also increases the risk of certain cancers.
Your doctor will evaluate your health history and determine if it is safe and worth it.
You can’t do anything to prevent the decrease of estrogen levels because it is unavoidable.
However, staying sexually active can help to delay the symptoms and make them more manageable. Sexual intercourse is almost as a workout for the vaginal muscles that keep them elastic and toned. Furthermore, it increases the blood flow, which supports healthier vaginal tissues.
Prevention also implies having a better lifestyle. Smoking affects the blood circulation and can impact on the levels of estrogen too, so quitting should be a priority.