Vaginal atrophy is a change of the vagina that develops when there is a significant decrease in levels of the female hormone estrogen leading to thin, dry and inflamed vaginal lining. As per Dr. Nitika Sobti, Principal Consultant, Obstretics and Gynaecology, Max Hospital Gurgaon, vaginal atrophy generally develops in women after menopause, postpartum and breastfeeding, women with surgical removal of ovaries or those taking certain medications (for treatment of breast cancer/uterine fibroids or endometriosis), premature menopause, etc. Also, there is a greater chance of vaginal and urinary infections in patients who have vaginal atrophy.
What causes vaginal atrophy?
Estrogen, which is produced by the ovaries, plays a key role in the lubrication of the vagina. A decrease in estrogen levels causes the vaginal lining to change resulting in:
- Lining becomes thin, less stretchy, reddish and swelled up, may have whitish discolouration as well.
- Vaginal canal may become narrow and shorten
- Decrease amount of vaginal fluid or secretions
- The acid balance of the vagina may change making vagina more prone to infections
Vaginal atrophy typically develops so slowly that a woman generally does not notice any symptoms until a few years after menopause begins. Using IUCD may also cause problems.
What are the symptoms of vaginal atrophy?
The symptoms of this condition are very similar to vaginal infections. This is why most women fail to recognize them. The noticeable symptoms of vaginal atrophy are:
- Dryness of the vagina
- Burning and/or itching of the vagina
- Pain during sex
- A discharge from the vagina
- Spotting or bleeding
There are several medical examinations to diagnose this condition. Your gynaecologist may ask you to get the following tests done:
- Pelvic exam
- Urine test
- Acid balance test of vaginal secretions
How can vaginal atrophy be prevented?
Here are some ways to prevent this condition as suggested by Dr. Sobti:
- Using a water-soluble vaginal lubricant to moisten the vaginal tissues and prevent painful sexual intercourse.
- Regular sexual activity also can help to prevent symptoms as it maintains the vaginal tissue by improving the blood circulation of the vagina.
Possible treatment of vaginal atrophy
Treatments may range from over-the-counter moisturizers to medications by prescription for hormone therapy. Here are the different treatment options:
- Vaginal moisturizers are used to restore some moisture to your vaginal area.
- Vaginal lubricants can be applied just before sexual activity to reduce discomfort during intercourse. Vaseline is NOT recommended since it can lead to fungal infections.
- Estrogen in low doses can be used in any form — oral, transdermal (skin patch), or vaginal, meant to treat only vaginal symptoms, like the rest of the body does not absorb it.
- Systemic estrogen therapy can be used if vaginal dryness is associated with other menopausal symptoms like moderate or severe hot flashes, reduced bone density, mood and sleep disturbances
- Topical lidocaine may be used to decrease the discomfort associated with sexual activity.
Apart from this, certain home remedies like using an over-the-counter moisturizer and lubricant can help. Vaginal lubrication that results from sexual arousal can help reduce symptoms of dryness or burning. Book an appointment with your doctor/ Obgyn specialist if you experience any vaginal dryness, bleeding, swelling, burning or itching, painful sexual activity. Annual screening by pelvic examination and investigations is generally recommended for all women above 40 years.
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