Vaginal Atrophy

Gynaecology

What are the Symptoms of Vaginal Atrophy?

  • Vaginal itchiness & Burning
  • Dryness & loss of lubrication
    • Incontinence & urinary urgency;
  • Vaginal & vulval pain
  • Painful sexual intercourse
  • Recurrent thrush and UTI’s
  • Prolapse
  • Vaginal laxity

Contributing Factors to Vaginal Atrophy Symptoms

The reduction of oestrogen production in the ovaries after menopause is the most recognised cause of vaginal atrophy.  This results in a reduction of collagen in the vaginal mucosa and thinning of the epithelium, which makes the vagina more susceptible to trauma during intercourse.  A concomitant reduction in blood flow leads to a decrease in vaginal secretions often leading to a dry vagina.  This in turn decreases the lactobacilli bacteria of the vagina which results in an increased pH level, facilitating the growth of pathogens such as yeasts and bacteria.  This can result in an unpleasant vaginal odour and recurrent thrush. 

Effective treatment of vaginal atrophy should start before the occurrence of vaginal changes and it is best to do so before the onset of vaginal atrophy.  

The challenges of vaginal atrophy

From the time menopause approaches a loss of estrogenic hormones can cause changes in the structure and function of the vagina.

The walls of the vagina lose collagen, become thinner and the natural elasticity and blood supply is reduced. The protective mucosa of the vagina can lose hydration and thickness, causing a loss of lubrication and changes in the natural balance of the internal environment. These symptoms can have a negative effect on your general well-being and, in many cases place stress on your intimate relationships.

Existing Treatment Options

Currently the most-common treatment of vaginal atrophy requires an ongoing application of hormone replacement creams directly into the vagina. For a variety of reasons some women are not able to use these creams, become uncomfortable with this process or are irregular with the application and eventually discontinue use.

Without an effective solution these women are forced to alter their lifestyle to cope with the symptoms.

 

Post-natal 

What happens to the vaginal walls after childbirth?

The most common short and long term effect after vaginal delivery is vaginal wall laxity, prolapse and urine incontinence. Childbirth stretches the vaginal skin and the birth canal. Giving birth is also associated with vaginal and perineal tears, scarring and more importantly vaginal atrophy, reducing both tone and strength of the vaginal walls. An overstretched vagina, can lead to urinary incontinence, reduce friction and sensation during intercourse for both partners. Women may also have trouble keeping tampons in place and may encounter gas-like noises during intercourse. For some women, sexual intercourse can be painful from dryness and scaring.

Vaginal tightening after childbirth

Tightening of the muscles and sphincters gives better control over contraction strength, resulting in heightened sexual enjoyment and eliminates undesirable effects such as prolapse and urinary incontinence. In most situations, the benefits of vaginal tightening kegel exercises are limited, especially for women who have had multiple children. 

Vaginal laxity is more common than you think

Vaginal Atrophy is a significant health issue affecting half of all women in their lifetime. However, with treatment, women can experience:

  • Better relationship with their partner
  • Improved sexual performance
  • Improved confidence
  • Enhanced sex drive
  • Enhanced reproductive health

Key Points to remember

  • Vaginal Atrophy is a significant health issue after child birth and for postmenopausal women
  • Vaginal Atrophy has implications on the female sexual response cycle and can negatively impact overall sexual function
  • Women often suffer in silence with this condition as a result of not knowing treatment is available

Any surgical or invasive procedure carries risks.
Before proceeding, you should seek  a second opinion from an appropriately qualified health practitioner.