What is vaginal atrophy?
Vaginal atrophy may also be referred to as vaginal dryness or atrophic vaginitis. Other terms you may hear being used include vulvovaginal atrophy (VVA) and Genitourinary syndrome of menopause (GSM)
The primary reason for vaginal atrophy is a deficiency in estrogen, which can lead to:
- Thinning of the vaginal tissue
- Reduction in the production of collagen (elastic tissue)
- Reduction in production of vaginal fluids
The vaginal tissue is very delicate and relies on a good blood flow, collagen and a natural release of fluid to maintain its integrity.
Collagen is important because it gives the vaginal tissue its elasticity, so that the walls of the vagina can contract and tighten.
Glands near the cervix naturally produce a lubricating fluid to keep the vagina supple and moist. The flow of the fluid also helps to keep the vagina clean by removing dead cells. The vaginal fluid is slightly acidic which helps to keep prevent infections, such as thrush.
Additionally, during sexual excitement the two glands at the entrance to the vagina produce additional moisture to aid sexual intercourse.
Other reasons for vaginal dryness in all women of all ages may be linked to the chemicals used in feminine hygiene products and some washing powders.
Some drug treatments such as allergy and cold medications and antidepressants can also dry out mucous membranes, including vaginal tissues.
Who is most affected by vaginal atrophy?
Vaginal dryness can affect women of all ages, but the most common sufferers are:
- Post-menopausal women (up to 60% may suffer)
- Women who have had breast cancer
- Breast feeding mothers
- Women who have had a hysterectomy
- Women who have had chemotherapy
What are the possible symptoms of vaginal atrophy?
- Vaginal dryness
- Vaginal burning
- Discomfort or painful intercourse
- Changes in vaginal discharge
- Genital itching
- Burning with urination
- Frequent urinary tract infections
- Urinary incontinence
- Light bleeding after intercourse
What can be done to help with symptoms?
- Use of vaginal lubricants and moisturisers
- Pelvic floor exercises
- Avoid perfumed soaps
- Use ‘neutral’ creams to treat skin irritation
Hormone (estrogen) treatment
- Pessary, which is inserted into the vagina with an applicator
- Vaginal rings
- Vaginal creams
It may take a few weeks before these start to work, so a non-hormonal lubricant is advisable in the early stages of treatment. Please also note that the benefits only last for as long as the treatment is being used.
- Hormone Replacement Therapy (HRT) – see previous articles: Hormone Replacement Therapy (HRT) part 1, Hormone Replacement Therapy (HRT) part 2 and Hormone Replacement Therapy (HRT) part 3
- Ospemifene (Senshio) – this is a drug which is like Tamoxifen which has a beneficial effect on VVA symptoms
- Laser treatment
Preliminary studies are showing encouraging results that this approach may be very helpful in relieving vaginal symptoms and may even be of benefit for urinary symptoms. This approach may be particularly helpful for women who cannot use estrogen treatment. Further studies are being performed to confirm initial findings.