What is it about menopause that leads to deterioration of vaginal health? Most answers revolve around Estrogen levels getting lower but how does the latter lead to the former?
The environment of the vagina has normal bacterial flora, just like the mouth or intestines, that serve certain good purposes. These normal vaginal bacteria keep the tissue healthy and protect against infection. Lactobacilli are the normal bacteria in the vagina. They produce lactic acid which keeps the vagina slightly acidic, preventing bacteria around the anus or other parts of the body from “invading.” However, Lactobacili require a healthy vagina high in Estrogen to thicken the vaginal lining to allow these to survive.
Atrophy, or thinning of tissue, occurs with loss of Estrogen following menopause. The degree of atrophy depends on multiple factors which helps explain a wide variety of symptoms. Up to 50 percent of menopausal women experience symptoms of genital atrophy, and with women living healthy longer, vaginal atrophy symptoms can lead to dramatic effects on quality of life.
What are some symptoms of atrophy?
Vaginal: burning, watery discharge, dryness, uncomfortable intercourse and itching.
Bladder: recurrent UTIs, frequency, urgency, burning with urination and waking at night frequently to urinate.
Bacteria can exist in the bladder in 20 percent of 70-year-old women, and this increases up to 50 percent by age 80. Close to 10 percent of women over the age of 60 will suffer from recurrent UTIs, which is defined as more than 2 UTIs per year. Once Estrogen levels drop, Lactobacilli fail to grow in the vagina, leading to a loss of acidity, which then allows harmful bacteria to propagate in the vagina and lead to infections.