Vaginal Atrophy – Symptoms, Causes & Treatment
Vaginal Atrophy, also called Postmenopausal Atrophic Vaginitis is a condition when the walls of vagina become thin because of decreased estrogen levels. This is typically seen in women who have reached menopause state. At times, this happens in women while they are in their perimenopause stage.
Menopause typically sets in when a woman reaches the age of 50 – 55 years. A woman is said to have reached menopause when she doesn’t have her periods for 12 continuous months. After menopause, it is typical for the vagina to become dry due to lower production of estrogen. This can lead to painful sex and bleeding/spotting may be seen after sex due to the rupturing of the vaginal walls. Further, the area can get infected and can lead to long term vaginal infections.
What causes Vaginal Atrophy?
As said already, the main reason for vaginal atrophy, thinning of vaginal walls is reduced production of estrogen by the ovaries in a woman. Along with thinning of vaginal walls, following symptoms may also be seen:
- Shortening and tightening of the vaginal canal.
- Vaginal dryness
- Spotting after intercourse
- Pain during urination
- Pain during intercourse
- Urinary Incontinence – Involuntary leakage of urine.
What are the reasons/causes of vaginal atrophy?
In a nutshell, it is due to the lower production of estrogen that makes the vaginal lining thin and dry. This begs the question, are there any other situations in a woman’s life when the levels of estrogen fall leading to vaginal atrophy?
Yes, there are other situations when the body of a woman produces relatively lower amounts of estrogen. They are:
- When breast feeding
- After removal of ovaries. (Ovaries produce estrogen).
- When undergoing chemotherapy, radiation therapy or hormonal therapy to treat cancer.
- Certain medications for other conditions may also affect the production of estrogen.
Will every woman suffer from vaginal atrophy?
Not really. Only some women suffer from vaginal atrophy and when they ignore the symptoms given by their body that can lead to spotting and vaginal infections that will need more doctor visits and consumption of more medicines.
Women who never delivered a baby through the vagina are at higher risk of vaginal atrophy. Smoking is another important risk factor.
Can vaginal atrophy lead to other problems?
Yes, if the dryness of vagina is not taken care, the thin lining of the vagina can break easily providing good entry point for microbes to enter the body and infect the vagina. Due to atrophy, the acidic nature of the vaginal fluids increases and that harbors growth of bacteria, yeast and other microbes leading to vaginal infections.
Sometimes, urinary tract may also get infected that causes burning sensation when passing urine. Women with urinary incontinence may feel the urge to pee immediately. Such women (with incontinence) are prone to more frequent and recurring urinary tract infections.
Diagnosing Vaginal Atrophy
If you do have a family physician, ask him/her to refer you to a good gynecologist near you or you can look for a good female gynecologist and see her for diagnosing and treating vaginal atrophy.
Your doctor will first start with a pelvic exam (done physically). You will have to tell him/her all your medical conditions, your current medications (if any), your lifestyle and if you are sexually active. Your doctor may then ask you to go for other tests including vaginal smear test, ph/acidity test, blood and urine test to determine the levels of estrogen, presence of bacteria or other microbes in urine etc.
Treating Vaginal Atrophy
If your gynecologist feels that putting you on estrogen supplements can get rid of the symptoms, he/she may put you onto synthetic estrogen. That can be in any form such as Topical gels, creams, vaginal ring that releases estrogen, vaginal pills etc.
If you have had hysterectomy done and uterus removed, just estrogen alone would suffice. In women with uterus, estrogen may have to be combined with progesterone in order to avoid the risk of endometrial cancer. (Endometrium is the inner layer of the uterus). Spotting may be seen in the initial days of treatment; if you see any unusual or recurring spotting or bleeding, let your gynecologist know immediately.
35 to 50% of women who reached menopause stage suffer from vaginal atrophy. When you see the symptoms, don’t hesitate to see a good gynecologist and openly discuss about your problem. Follow the treatment schedule and be in touch with your doctor until the symptoms subside and enjoy your happy life.