Vaginal Atrophy

Vaginal atrophy is a condition in which the vaginal wall becomes thinner, dryer and inflamed. It is the result of lowering estrogen levels.

This can lead to vaginal pain, pain during sexual intercourse, loss of sex drive and urinary tract infections.

Other symptoms include:

• Dryness and soreness
• Burning in the vagina or when you urinate
• Feeling that you need to urinate all the time
• Urinary incontinence (not being able to stop the flow of urine)

• Bleeding after sex
• Feeling tight or as if your vagina is shorter than usual.

Some women don’t have any noticeable symptoms.

The condition is most common in women who have experienced menopause because this naturally leads to a lowering of estrogen, and estrogen is needed for good vaginal health. Women who are breastfeeding are also more at risk, although the problem is temporary and will correct itself after the child has weaned.

Other higher risk groups are:

Women who have had chemotherapy or radiotherapy to the pelvic area
Women who have had their ovaries removed (for instance, because of cancer)
Women who take medicines for fibroids or endometriosis
Women who smoke
Women who have never given birth vaginally

Diagnosis

Vaginal atrophy is diagnosed by a doctor’s examination. He or she will examine your external genitalia (vulva, labia etc.) and your vagina to check for signs of atrophy. Samples of urine and vaginal discharge may also be taken and you may be offered a smear test to rule out malignancies or other changes to the cervix.

Treatment

Treatment depends on the woman’s medical history and on her symptoms. If symptoms are only mild, she may be able to use home remedies instead of prescription drugs.

Home remedies include:

Sexual lubricant
If a lubricant is used it can ease dryness and soreness and make sex more comfortable. Avoid brands with parabens in them as some scientists say that parabens can be absorbed into the body and the body then mistakes them for estrogen. Although this may relieve some of your symptoms, it may be dangerous for people with other health conditions and cancer.

There is a brand made with the vine of kiwi fruit that does not contain parabens. If you live in the U.K. it is available for free on NHS prescription. Please see the sources for this article if you are interested.

Frequent sexual intercourse
This may sound contradictory, but the more you have sex, the more the muscles stretch and the easier it should become. If you find sex too painful, you can experiment with non-penetrative sex that may relax you and ease symptoms.

Vaginal dilators
These are available from your doctor. You use them in the privacy of your own home, to gently stretch vaginal muscles. You start with a small one and gradually work your way up to a larger size. This should make sex easier.

Estrogen diet
Eating plenty of foods rich in estrogen could help, particularly if your vaginal atrophy is the result of menopause. Foods containing high estrogen are soy beans, soy products like tofu, miso and tempeh, flax seeds, fruit such as apples, cherries, dates, olives and plums and vegetables such as carrots, chickpeas, cucumber, garlic, peas, peppers, potatoes and various beans.

Wheat, rice and dairy products are also high estrogen. Incorporating lots of these into your diet may reduce the symptoms of menopause.

There are also HRT diet books available to help you. Don’t try this if you have ever had a hormone dependent cancer.

Cranberry juice
Drinking cranberry juice can ward off urinary infections associated with vaginal atrophy.

Medical Treatments

Medical treatment is available for moderate to severe symptoms in the form of topical or systematic estrogen replacement (HRT). This is given via ointment, gel, patch or tablet.

The systematic HRT can have many side-effects including heart attack and stroke, which should be considered before choosing this treatment.

Topical HRT is unlikely to have these same risks so is the safer option. Vaginal topical estrogen may also reduce urinary tract infections and overactive bladder.

Sources:

Vaginal Atrophy Leaflet, The Hormone Foundation. Web. 12 March 2012. http://www.hormone.org/Resources/upload/Vaginal-Atrophy-Bilingual-WEB.pdf

Vaginal Atrophy: Tests and Diagnosis, The Mayo Clinic. Web. 12 March 2012. http://www.mayoclinic.com/health/vaginal-atrophy/DS00770/DSECTION=tests-and-diagnosis

Sylk: The Natural Lubricant, FAQ’s. Web. 12 March 2012. http://www.sylk.co.uk/faqs

About Sylk, Sylk USA. Web. 12 March 2012.
http://sylkusa.com/about-our-products

Foods Containing Natural Estrogens, Holistic Online. Web. 12 March 2012. http://www.holisticonline.com/Remedies/hrt/hrt_food_and_estrogen.htm

How Cranberry Juice Can Prevent Urinary Tract Infections, Science Daily. Web. 12 March 2012. http://www.sciencedaily.com/releases/2008/07/080721152005.htm

Joanna is a freelance health writer for The Mother magazine and Suite 101 with a column on infertility, http://infertility.suite101.com/
She is author of the book, "Breast Milk: A Natural Immunisation", and co-author of an educational resource on disabled parenting.

Reviewed March 12, 2012
by Michele Blacksberg RN
Edited by Jody Smith

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