Vaginal atrophy — signs, symptoms and treatment
ATROPHY is a term used to describe the process of something wasting away, or diminishing in quality. This happens to a lot of things, whether from the passage of time, poor maintenance, degeneration, or lack of use. And believe it or not, it happens to vaginas too.
Vaginal atrophy is a condition that results from a reduction in the hormone oestrogen, explained consultant obstetrician-gynaecologist Dr Kimberly Martin.
She explained that one of the most common symptoms is a ‘drying up’ of a once moist vagina.
“Patients may experience vaginal dryness during daily activities, and decreased lubrication during sexual activity, painful intercourse, vulvar or vaginal burning, itching, irritation, vaginal discharge and even bleeding,” she said. “Urinary symptoms such as frequent and painful urination, as well as urinary tract infections, may also occur.”
Dr Martin noted that these symptoms may begin as mild discomfort, which might worsen over time if left untreated. She added that it usually strikes women after menopause.
“Its prevalence is really not well established,” she shared. “Few studies have been done, but an international survey of over 4,000 menopausal women reported that 39 per cent of them had experienced vaginal discomfort related to menopause.”
She explained that women can also suffer from vaginal atrophy before menopause.
“Conditions or medications that reduce the oestrogen in the body may also cause atrophic changes in pre-menopausal women,” she stated. “It may occur in patients who have had their ovaries removed or had premature ovarian failure. Some medications used to treat certain conditions cause a reduction in the hormone. These include Tamoxifen used at times in patients with breast cancer and even hormones like leuprolide, which is sometimes used in patients with endometriosis, as well as chemotherapy or radiation which may cause ovarian failure.”
Dr Martin urges women who suffer from any of the abovementioned symptoms to consult their gynaecologists, because while the atrophying cannot be undone, they can receive relief from the discomfort.
“First line therapy involves the use of non-hormonal vaginal lubricants during intercourse. This will improve discomfort but does not reverse the atrophic changes. If infection is present, that will also be treated at the time of consultation with your doctor,” she said.
She explained that the condition is diagnosed when your history of symptoms, as well as the results of your pelvic exam, match those associated with the condition.
“Classical findings may include, but are not limited to, pale, dry, smooth tissue lining the vagina with features of inflammation,” she divulged. “Your doctor will also be able to exclude other conditions that may cause irritation of the vulva and vagina — for example, infections and dermatological changes involving the vulva.”
Dr Martin said, too, that hormone therapy is available in extreme cases.
“For women with persistent symptoms that affect their quality of life, then it can be determined by her doctor if she is a suitable candidate for low dose local oestrogen therapy, other hormone therapy or other modalities,” she shared. “A comprehensive evaluation and discussion with your physician is important to determine what is best for you.”
