Vaginal atrophy is a condition that can affect women as they age, particularly during and after menopause. It occurs when the tissues of the vagina become thinner, drier, and less elastic due to a decrease in oestrogen levels. While this condition is common, it is often underreported and can lead to discomfort and distress. Let’s explore the causes, symptoms, treatment options, and lifestyle changes that can help manage vaginal atrophy.

What is vaginal atrophy?

Vaginal atrophy refers to the thinning and inflammation of the vaginal walls, which happens primarily due to a drop in oestrogen. Oestrogen plays a key role in maintaining vaginal health by promoting the production of lubrication, maintaining the thickness of vaginal tissues, and supporting a healthy pH balance. As women approach menopause, oestrogen levels naturally decline, and this can lead to changes in the vaginal area.

Although vaginal atrophy is most commonly associated with menopause, it can also occur during breastfeeding or as a result of certain medical treatments such as chemotherapy or radiation.

Common symptoms

Vaginal atrophy can be distressing, but its symptoms are often manageable with the right care. Common symptoms include:

• Vaginal dryness: a feeling of dryness or lack of natural lubrication is one of the first signs.
• Itching or burning: the thinning vaginal walls can lead to irritation, itching, or a burning sensation, especially during intercourse.
• Pain during sex (dyspareunia): the lack of lubrication and the thinning of vaginal tissues can make sexual activity painful, which can affect intimacy and quality of life.
• Frequent urinary tract infections (UTI): the vaginal tissue’s inability to resist infections may increase the likelihood of UTIs, which cause symptoms like frequent urination or a burning sensation while urinating.
• Increased vaginal discharge: some women may notice an increase in vaginal discharge or an unusual odour due to changes in the vaginal environment.
• Bleeding or spotting: postmenopausal women or those with low oestrogen may experience unusual vaginal bleeding or spotting.

When to seek medical advice

If you are experiencing symptoms of vaginal atrophy, it is important to seek medical advice. A healthcare provider will typically perform a pelvic exam to check for signs of thinning vaginal walls and may ask about your symptoms, health history, and lifestyle.

If they suspect vaginal atrophy, they may suggest treatment options to restore moisture to the vaginal tissues, alleviate discomfort, and improve overall vaginal health. Treatment options may include:

1. The most common treatment for vaginal atrophy is oestrogen therapy, which can be administered locally (such as creams, vaginal rings, or tablets) or systemically (oral or transdermal). Local oestrogen therapy is often preferred because it targets the vaginal area directly with fewer side effects.

2. Non-hormonal lubricants and moisturisers: over-the-counter lubricants and vaginal moisturisers can provide temporary relief from dryness and discomfort during sexual activity. These products can be used as needed for daily comfort.

3. Pelvic floor exercises: regular pelvic floor exercises better known as kegel exercises may help strengthen vaginal muscles, improve blood flow, and provide relief from vaginal dryness and discomfort.

4. Lifestyle changes: healthy eating, staying hydrated, avoiding douches, using gentle soaps, and wearing breathable cotton underwear can also help manage symptoms.

Emotional impact

Vaginal atrophy can take a toll on a woman’s emotional well-being. It can lead to a decrease in self-esteem, anxiety about intimacy, and a sense of frustration or embarrassment. It’s essential to communicate openly with a healthcare provider about the emotional aspects of this condition. Many women find that discussing these issues helps to reduce feelings of isolation and can lead to more comprehensive treatment plans.

Vaginal atrophy is a common but often under-discussed condition that affects many women, especially as they approach menopause. Understanding the causes, symptoms, and available treatment options can help you take control of your health and manage this condition more effectively. If you are experiencing any of the symptoms of vaginal atrophy, don’t hesitate to book an appointment.