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Vaginal atrophy refers to the thinning and inflammation of the vaginal wall that occurs during menopause. This is due to a decline in estrogen. Less circulating estrogen makes the vaginal tissues thinner, drier, less elastic and more fragile. Vaginal atrophy does not just happen during menopause. It can also develop during breastfeeding or at any other time when the body's estrogen production declines.
Vaginal atrophy is a common complaint among postmenopausal women. By some estimates, about half of postmenopausal women experience it. While it does not have serious consequences, it can be a source of significant discomfort for many.
Vaginal atrophy signs and symptoms include vaginal dryness, itching, irritation, and/or pain during sexual intercourse. If the lining of the vagina becomes thin enough, it can even result in some vaginal bleeding. This thinning also makes women more susceptible to infections with bacteria, yeast or other organisms, which could result in a foul odor and discharge.
Atrophic vaginal changes can also be associated with changes in the urinary system. This can cause urinary problems like increased frequency or urgency of urination or burning with urination. Some women experience more urinary tract infections or incontinence.
Vaginal atrophy does not need to be treated unless it causes discomfort. If that happens, there are several effective treatments.
Hormone therapy (HT) is one. HT has been shown to reduce vaginal dryness. However, whether or not to use hormone therapy is an individual decision. One must consider the risks and benefits of such treatment. It is a good idea to speak with your health care provider about HT.
Topical or oral estrogen is effective in relieving vaginal dryness and itchiness, and improving vaginal elasticity. Vaginal estrogen has the advantage of being effective at lower doses and limiting overall exposure to estrogen. These include the vaginal estrogen ring, cream or tablets. Estrogen applied directly to the vagina can still result in estrogen reaching the bloodstream, but the amount is minimal.
There are non-hormonal options for the treatment of vaginal atrophy.