Vaginal atrophy

By Medically reviewed by Hello Doktor Medical Panel

Definition

What is vaginal atrophy?

Vaginal atrophy (atrophic vaginitis) is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after menopause.

For many women, vaginal atrophy not only makes intercourse painful, but also leads to distressing urinary symptoms. Because of the interconnected nature of the vaginal and urinary symptoms of this condition, experts agree that a more accurate term for vaginal atrophy and its accompanying symptoms is “genitourinary syndrome of menopause (GSM).”

Simple, effective treatments for genitourinary syndrome of menopause — vaginal atrophy and its urinary symptoms — are available. Reduced estrogen levels result in changes to your body, but it doesn’t mean you have to live with the discomfort of GSM.

How common is vaginal atrophy?

Between 10 and 40 percent of women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent will seek medical help. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of vaginal atrophy?

The common symptoms of vaginal atrophy are:

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

You should contact your doctor if you have any of the following:

  • Painful intercourse that’s not resolved by using a vaginal moisturizer or water-based lubricant (glycerin-free versions of Astroglide, K-Y Intrigue, others)
  • Vaginal symptoms, such as unusual bleeding, discharge, burning or soreness.

Causes

What causes vaginal atrophy?

Genitourinary syndrome of menopause (GSM) is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile.

A drop in estrogen levels may occur:

  • After menopause
  • During the years leading up to menopause (perimenopause)
  • After surgical removal of both ovaries (surgical menopause)
  • After pelvic radiation therapy for cancer
  • After chemotherapy for cancer
  • As a side effect of breast cancer hormonal treatment

GSM signs and symptoms may begin to bother you during the years leading up to menopause, or it may not become a problem until several years into menopause. Although the condition is common, not all menopausal women experience GSM. Regular sexual activity, with or without a partner, can help you maintain healthy vaginal tissues.

Risk factors

What increases my risk for vaginal atrophy?

There are many risk factors for vaginal atrophy, such as:

  • Cigarette smoking affects your blood circulation, resulting in the vagina and other tissues not getting enough oxygen. Smoking also reduces the effects of naturally occurring estrogens in your body. In addition, women who smoke typically experience an earlier menopause.
  • No vaginal births. Researchers have observed that women who have never given birth vaginally are more likely to develop GSM than women who have had vaginal deliveries.
  • No sexual activity. Sexual activity, with or without a partner, increases blood flow and makes your vaginal tissues more elastic.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is vaginal atrophy diagnosed?

The doctor will carry out an examination and ask about medical history. They may ask about the use of agents that can irritate the area and cause or aggravate symptoms, such as soaps or perfumes.

The pH, or acidity, of the vaginal area is also taken. A pH of 4.6 or higher indicates atrophic vaginitis. The normal pH of this area is 4.5 or less.

The doctor may also request an infection screening, especially in cases of discharge or bleeding. A diabetes test may be performed to rule out diabetes.

Examples of infections that may also be presenting include candidiasis, endometritis, and bacterial vaginosis. Atrophic vaginitis can make the area more susceptible to becoming infected. It can occur alongside an infection.

If the diagnosis is unclear, or malignancy is suspected, a biopsy may be taken to rule out cancer.

A vaginal examination is likely to cause discomfort or pain in a patient with atrophic vaginitis.

How is vaginal atrophy treated?

Topical treatments can help.

A water-soluble vaginal lubricant may help to provide relief during intercourse, for mild cases.

Petroleum jelly, mineral oil, or other oils are not suitable. These may increase the chance of infection and may damage latex condoms or diaphragms.

Hormone replacement therapy (HRT), as a tablet, gel, patch, or implant can supply estrogen to the whole body. It is effective, but there may be side effects. Patients should discuss the risks of long-term HRT with their doctor.

Localized HRT is applied topically and focuses treatment on the affected area. A low-dose estriol cream can be used to stimulate rapid reproduction and repair of the vaginal epithelium cells.

Vaginal tablets, creams, rings, and pessaries can be applied internally to focus the supply of estrogen to the vaginal area.

Regular exercise is important as it keeps blood flow and genital circulation high. Experimenting with the diet can also prove effective. Plant estrogens, linseeds, fish oils, and black cohosh can help relieve atrophic vaginitis.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage vaginal atrophy?

The following lifestyles and home remedies might help you cope with vaginal atrophy:

  • Try an over-the-counter moisturizer. This can restore some moisture to your vaginal area.
  • Use an over-the-counter water-based lubricant. This can reduce discomfort during intercourse.
  • Allow time to become aroused during intercourse. The vaginal lubrication that results from sexual arousal can help reduce symptoms of dryness or burning.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

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