Vaginal atrophy, also known as atrophic vaginitis, is a condition that most women experience much later in life. It is a medical condition typically occurs during menopause and is caused by a decrease in estrogen levels. However, it can also develop during breast-feeding or whenever the body decreases its production of estrogen.
What Is It?
Vaginal atrophy is an inflammation of the vagina due to the thinning of the vaginal walls caused by lower estrogen levels, which typically occur during menopause. Estrogen is responsible for maintaining the health of tissues within the vagina, keeping them well lubricated to minimize irritation and also to make sexual intercourse more pleasurable. As the vaginal walls become dry and thin, irritation and inflammation become an issue.
For many women, low estrogen levels occur as part of natural physical processes, especially when they are breastfeeding and going through menopause. When estrogen levels become low, the symptoms of vaginal atrophy will become more pronounced. Vaginal atrophy can cause varying levels of discomfort and can affect a woman's ability to enjoy sex. Regardless of whether sexual intercourse is uncomfortable, a woman's sex drive will gradually decrease as her estrogen levels diminish.
Causes And Risk Factors
Aside from menopause and breast-feeding, there are other factors that can cause decrease a woman’s estrogen levels, resulting in vaginal atrophy. These factors include:
- Strenuous exercise
- Removal of the ovaries
- Medical treatments that can affect a woman’s estrogen levels through the administration of certain medications or hormones. Radiation and chemotherapy treatments to the pelvic area can also result in lower estrogen levels
Vaginal atrophy cases may vary, where some women may experience the condition during their years leading up to menopause, while others may experience it several years after menopause. There is even a chance that a woman will not develop vaginal atrophy at all after having experienced menopause.
Risk factors that may lead to vaginal atrophy include:
- Smoking: Smoking limits blood circulation, which can affect the amount of oxygen that travels to the vagina. It can also have an effect on the estrogens in the body.
- Never giving vaginal birth: Studies have shown that women who have never given vaginal birth are at a higher risk for developing vaginal atrophy.
Aside from dryness and irritation of the vagina, there are several symptoms to watch out for when dealing with vaginal atrophy:
- Burning sensation, especially when urinating
- Hurried urination
- High susceptibility to urinary tract infections
- Urinary incontinence
- Bleeding after intercourse
- Vaginal discharge
- Pain during sexual intercourse, causing a decrease in a woman’s desire to have sex
- Vaginal itching
When To Seek Medical Attention
According to Mayo Clinic, roughly half of postmenopausal women experience vaginal atrophy, but very few seek treatment. This can be out of embarrassment or sheer acceptance of physical changes due to age. However, there are treatments available that can alleviate symptoms of vaginal atrophy. Simply ignoring this medical condition can also lead to further health complications. Women who begin to experience pain during intercourse that cannot be remedied with lubricant or moisturizer, unusual bleeding or discharge from the vagina, and burning or soreness from the vagina should seek medical attention.
While vaginal atrophy can lead to several complications involving urination and sexual intercourse, the primary cause for concern is an increase in vaginal infections. Since vaginal atrophy has a direct effect on the acidic environment of the vagina, there is a higher risk of infection, or vaginitis. These infections may be caused by bacteria, yeast and/or other organisms. Vaginal atrophy can also cause sores, cracks and other abrasions around the vaginal wall due to dryness and sensitivity.
Due to the varying degrees of vaginal atrophy, there are different levels of treatment that are effective at relieving symptoms and discomfort. For mild symptoms, over-the-counter medication in the form of vaginal lubricants and moisturizers can be applied for relief. Lubricants can also be applied before intercourse for pain relief. Be sure to use the water-soluble variety of lubricants, as the ingredients in the other types of lubricants can possibly damage condoms or diaphragms.
In more severe cases of vaginal atrophy, hormone replacement therapy may be introduced in the form of topical or oral estrogen. These prescribed medications allow estrogen to directly enter vaginal tissues, or be absorbed through the bloodstream. Topical estrogen can come in the form of a cream, estrogen ring or tablet, all of which are inserted into the vagina. Oral estrogen can come in the form of a pill, patch or gel, and can enter the bloodstream directly.
The main form of prevention for vaginal atrophy is maintaining regular, sexual activity. This can be done with or without a partner and can help increase blood flow to a woman’s vagina. The increased blood flow can be used as a countermeasure to the lack of lubrication affecting vaginal tissues. The application of lubricant can help alleviate any discomfort caused by vaginal atrophy during sexual activity.