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Women’s health- Vaginal Atrophy

What is Vaginal Atrophy?

Vaginal dryness can cause irritation, burning, and pain with intercourse. It’s common after menopause, and it also can happen in the years leading up to menopause. Often, my patients notice symptoms when they haven’t been sexually active for a long time. Then they are intimate with a partner and find that sex is painful.

Traffic Sign Pointing To The “Menopause”Vaginal atrophy is the thinning and drying of the vaginal walls. This is a rather common condition, sometimes referred to as vulvo-vaginal atrophy (VVA), atrophic vaginitis or Genitourinary Syndrome of Menopause (GSM).It affects up to 1 in 3 women, most often during or after the menopause when the cells in the vagina are most lacking in hydration and the body may fail to produce enough oestrogen. This results in the drying, thinning and inflammation of the vagina, which can understandably cause a lot of stress and discomfort.

While it can occur at any age, it is estimated that almost half of post-menopausal women experience vaginal atrophy. However, the condition is not widely discussed and as such, few seek treatment. Many women believe it is a normal consequence of menopause and resign themselves to suffering in silence.

What are the Symptoms of Vaginal Atrophy?
There are several symptoms associated with vaginal atrophy, ranging from moderate to severe. Some women will experience a number of these, while others may only have one or two.

Symptoms include:
Vaginal dryness
Redness and itching of the genitalia
Burning sensation in the vagina
Burning sensation when urinating
Urgency with urination
Urinary incontinence
Frequent water infections, or urinary tract infections (UTIs)
Painful intercourse; decreased lubrication during sexual activity
Bleeding or discomfort after intercourse
Tightening and shortened

Reports have suggested that nearly half of post-menopausal women will fail to visit their doctor when experiencing vaginal atrophy, maybe through embarrassment or perhaps because they believe it to be a ‘normal’ part of the ageing process. However, nobody should have to suffer, so it is important to seek medical treatment when any of these symptoms are affecting your everyday life.

Since there is a strong link between the vaginal and urinary symptoms associated with vaginal atrophy, some experts tend to agree that a more suitable term for it is “genitourinary syndrome of menopause” (GSM), so it is useful to also be aware of this terminology when doing your research.

What Causes Vaginal Atrophy?
Vaginal atrophy occurs because of the lack of oestrogen production in the body, resulting in thinner, drier, and less elastic vaginal tissue. While menopause is the most common cause of vaginal atrophy, there are several other triggers too, including:
The years leading up to menopause (perimenopause)
Pelvic radiotherapy
Hormonal cancer treatments
Removal of both ovaries (surgical menopause)
An underlying condition like diabetes or Sjogren’s syndrome, but these are less likely causes
Other risk factors that have that have been known to contribute towards the condition are; not having given birth vaginally, and smoking, which may also trigger early menopause.

What Else Can Cause Vaginal Dryness?
Menopause is not the only cause of vaginal dryness. Not being sexually aroused during intercourse or foreplay is a common reason for vaginal dryness. Additionally, upsetting the vagina’s natural pH balance by using perfumed products or soaps in your intimate area can irritate the vagina.

Some types of medication, such as antidepressants or the contraceptive pill, can also cause vaginal dryness. Moreover, if you are breastfeeding and how low oestrogen levels as a result, you may experience vaginal dryness

Is Vaginal Dryness Preventable?
Although vaginal dryness is quite common, there are certain preventative measures you can take. Avoid using perfumed products, shower gel or deodorant in/around your intimate areas, as doing so can upset the natural pH balance.

Using a lubricant during sex can also help prevent vaginal dryness while spending a longer time on foreplay can help your body produce lubricant naturally. In fact, many experts suggest that regular sexual activity before, during and after the menopause, using lubricants where necessary, can help maintain healthy vaginal tissue, therefore alleviating some of the symptoms or even avoiding vaginal dryness completely.

How is Vaginal Atrophy Diagnosed?
A vaginal atrophy diagnosis can be made after an examination of the vaginal area by a doctor or gynaecologist. A pH (potential hydrogen) test is also carried out to determine if the pH levels are normal. If vaginal atrophy is detected, then your doctor or gynaecologist can discuss the several different potential treatment options with you

Can Vaginal Atrophy be Treated?
Tablets for Hormone Replacement Therapy
Several simple and effective treatment options for vaginal dryness (vaginal atrophy) exist, such as hormone replacement therapy tablets, topical oestrogen in the form of pessaries, vaginal rings, or vaginal creams, and over-the-counter moisturisers or lubricants.

Not all cases of vaginal dryness need medical attention, however, it is wise to visit your doctor or gynaecologist when self-help methods, such as lubricants or vaginal moisturisers, are not effective, or when symptoms are severe and therefore affecting your day-to-day life.

For those whose vaginal atrophy is severe, a new treatment option exists called the MonaLisa Touch® which involves laser therapy and is quick and pain-free.


Multidisciplinary Overview of Vaginal Atrophy and Associated Genitourinary Symptoms in Postmenopausal Women:

5 Signs of Vaginal Atrophy:

Experiencing Vaginal Dryness? Here’s What You Need to Know:



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