Are you in menopause or have you already been through it and experienced vaginal burning or pain during intercourse? Then you may be suffering from vaginal atrophy, a very common problem for women at this stage. Join us and find out more about this condition!

What is vaginal atrophy?

Vaginal atrophy is a condition involving thinning, swelling, and dryness of the vaginal walls (Mayo Clinic, 2021). It is estimated that at least 50% of women 7-10 years after menopause have atrophic vaginitis. And as they get older, up to 75% may have this condition (Naumova & Castelo, 2021).

How and why does vaginal atrophy occur?

A decrease in estrogen production during menopause is the main cause of atrophy in the vagina. Estrogen helps maintain the flexibility and strength of vaginal tissues. When estrogen levels fall below normal, vaginal walls become more fragile, leading to the onset of atrophy (Flores & Pasillo, 2021).

Risk factors

Some factors that can increase the risk of suffering from this problem, such as (Mayo Clinic, 2021):

Not having had a vaginal birth

It seems contradictory; however, according to some specialist research, women who have never given birth vaginally are more likely to develop atrophic vaginitis.

Lack of sexual activity

During sexual intercourse, there is an increased blood supply to the genital area, which helps the vaginal walls. As a result, the elasticity of the vagina remains in good condition over time.

Smoking

Nicotine affects blood circulation. As a result, the levels of oxygen and blood flowing to the vagina may be reduced. This can also lead to atrophic vaginitis.

Signs and symptoms of vaginal atrophy

Here are some of the symptoms that serve as warning signs when identifying this condition (Calhoun, 2019):

• Bleeding and discomfort during and after intercourse.
• Frequent urination and/or urine leakage.
• Narrowing of the vagina or vaginismus.
• Pelvic pain.
• Vaginal discharge, itching, burning, or dryness.
• Lack of lubrication during sexual intercourse when this condition has never occurred before.
• Pain or burning during urination.

Atrophic vaginitis is also a major risk factor for the development of yeast infections and recurrent UTIs (Calhoun, 2019).

Diagnosis

This condition is usually diagnosed by pelvic examination. If the gynecologist observes swollen, thinned, pale, or reddened vaginal walls, he or she will confirm that it is atrophy of the vagina (Mayo Clinic, 2021).

Treatment overview

There are several treatments for vaginal atrophy. Among the most effective are:

Change in lifestyle habits

Smoking cessation is suggested, as well as increasing your intake of fluids, vegetables, legumes, and fruits (Mayo Clinic, 2021). This may help prevent this condition during menopause.

Hormone replacement therapy

This therapy involves the oral intake of hormones such as estrogen. The aim is to restore some of the hormones the body has lost and alleviate the symptoms of menopause (Flores & Pasillo, 2021).

Topical therapy

This consists of the use of creams and gels in the genital area to alleviate symptoms. Among the most popular topical treatments are (Dos Santos et al., 2021; Flores & Pasillo, 2021):

• Estrogen cream. These include hormones (estrogens) in their composition. So, they provide the genital area with a small amount of the hormone that is no longer produced by the body itself.
• Water-based lubricants. They can reduce genital discomfort, especially during sexual intercourse.
• Hyaluronic acid creams. These are moisturizers that help to eliminate vaginal dryness. Evidence shows that they are safe and similar in effectiveness to estrogen creams.

Vaginal atrophy is a menopausal disorder caused by a decrease in estrogen levels. However, it is possible to improve your symptoms and have a better quality of life. We invite you to visit your doctor to discuss the best treatment option for you.

Bibliography

• Calhoun, S. (2019, March 7). Postmenopausal atrophic vaginitis. Healthline. https://www.healthline.com/health/atrophic-vaginitis
• Dos Santos, C., Uggioni, M., Colonetti, T., Colonetti, L., Grande, A.J., and Da Rosa, M.I. (2021). Hyaluronic Acid in Postmenopause Vaginal Atrophy: A Systematic Review. The journal of sexual medicine, 18(1), 156-166. https://doi.org/10.1016/j.jsxm.2020.10.016
• Flores, S., & Pasillo, C. (2021, November 5). Atrophic vaginitis. Treasure Island (FL): StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK564341/.
• Mayo Clinic. (2021, September 17). Vaginal atrophy. https://www.mayoclinic.org/es-es/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288#:~:text=The%20atrophy%20vaginal%20(vaginitis%20atr%20atr%C3%B3phic,frequency%20after%20menopause.
• Naumova, I., & Castelo-Branco, C. (2018). Current treatment options for postmenopausal vaginal atrophy. International journal of women's health, 10, 387-395. https://doi.org/10.2147/ijwh.s158913.