Team Inspiriko - August 2022
Vaginal Atrophy: Signs, Symptoms, and Causes
Vaginal atrophy may have a scary name, but don’t be intimidated by it. It refers to the general dryness and inflammation of the vagina that typically takes place during menopause, as your female hormone levels drop and this causes your vagina to become thin and inflamed (1). Although this is many times a completely normal and natural part of becoming older, it can be uncomfortable and even painful, altering your quality of life.
Do you suspect you’re suffering from vaginal atrophy? Here we provide you with all the information you need about this condition, how to identify it, and when to consult with your doctor.
What is Vaginal Atrophy?
During the menopause stage, the female body experiences many changes that go from night sweats to mood swings and cramps. But it doesn’t stop there: during the years leading to menopause (also called perimenopause), it’s possible to suffer from vaginal atrophy. This refers to the thinning and drying of the vaginal walls that take place due to the lack of estrogen your body goes through.
Dryness is usually the first symptom women experience: around 93% of women with vaginal atrophy report this symptom (2). This leads to inflammation and a burning sensation, especially after having sex or when urinating. That is why vaginal atrophy is many times referred to as Genitourinary Syndrome of Menopause (GSM). Plus, as your vaginal tissues become thinner and thinner, you are likely to develop more frequent urinary infections (3).
Most women experience vaginal atrophy or GSM after menopause, so they usually are 50 years old (or older). Only a small percentage of women (around 15%) present with vaginal atrophy before menopause happens (4).
The good news is that there are effective solutions available, natural and traditional, to help you regain your health and well-being. But first, you need a good diagnosis. These are the signs and symptoms to watch out for to recognize vaginal atrophy (5):
● Itching and/or burning
● Vaginal dryness, even during intercourse
● Discharge
● Recurrent UTIs
● Discomfort during sex
● Painful tightening of the vagina
Vaginal atrophy can also bring about symptoms related to your urinary system, namely:
● Frequent urination
● Burning and/or itching when urinating
● Pain when going to the bathroom
● Frequent UTIs
● Blood present in the urine
Other Causes of Vaginal Atrophy
Vaginal atrophy is always caused by a drop of female hormones in the body, but menopause is not the only thing that can cause this drop. These are some of the reasons why you may experience lower levels of hormones (6):
● Perimenopause,
● Going through surgery to remove the ovaries or womb (hysterectomy or oophorectomy),
● Breast-feeding,
● Smoking,
● Not having regular sex,
● Getting radiation or chemotherapy,
● Allergies.
How Does Vaginal Atrophy Impact Sex Life
The pain, dryness and general discomfort caused by vaginal atrophy can have an impact on your sex life. What in the past was once an enjoyable experience can now turn into a painful nightmare, no matter how much foreplay you carry out.
The first thing to understand is that there’s nothing “wrong” with you. Most women experience vaginal atrophy at some point or another and, most importantly, there are solutions available to relieve your symptoms. Let’s explore them below.
TAKE THE MENOPAUSE ASSESSMENT
Learn where you are in your menopause / perimenopause journey with the help of a personalised report.
START ASSESSMENTWhat Can You Do About Vaginal Atrophy
Today, you have a number of solutions at your disposal so you can do away with the symptoms and recover your health. Let’s cover both traditional and natural solutions so you and your doctor can decide which one is better for you.
Natural Solutions for Vaginal Atrophy
You can adopt different lifestyle changes to experience relief from your symptoms naturally (7), such as:
● Stay sexually active, even if you don’t have a partner, to maintain good blood flow to your genitals.
● Exercise regularly to maintain your hormones well balanced.
● Stay hydrated to increase general moisture in your body (and your vagina, too).
● Start using moisturizers and lubricants to do away with dryness and discomfort. While lubricants are used in the short term (usually, during intercourse), moisturizers have a long-lasting effect and are to be used daily.
● Some studies suggest that ingesting enough probiotics can be helpful for women with vaginal atrophy (8), as there seems to be a relationship between the vaginal and the intestinal flora. Probiotics are usually present in fermented foods like kimchi, yogurt or pickles, so incorporating them into your diet can help you manage symptoms of vaginal atrophy.
Hormonal Treatments
Your doctor may decide that hormonal therapy is appropriate to deal with the the root cause of your symptoms: the lack of estrogen. One option is Hormone Replacement Therapy, where pills or intravaginal rings replace the hormones you have lost. Research shows that this therapy is highly effective when treating vaginal atrophy in 75% of cases (9).
What Should You Avoid to Ease Symptoms
While you look for appropriate solutions for vaginal atrophy, here are some things you should avoid to ease your symptoms:
● Try not to use perfumed products, like powders or soaps, as they can irritate your vagina and make symptoms worse.
● Quit smoking, as nicotine can cause imbalances in your hormones and make symptoms worse (10).
● Avoid vaginal douches or bubble baths, as they can alter your vaginal flora and heighten your symptoms even more.
● Your choice of underwear can help ease irritation. Avoid synthetic clothes, as they can trap sweat and produce even more itching and burning. Go for cotton, instead!
When Should You See a Doctor
Vaginal atrophy many times goes undiagnosed, either because many women are ashamed of asking for help or because they assume there’s nothing to do about this issue.
If you experience pain, abnormal discharge, burning and itching, or if you’re simply worried you may be suffering from vaginal atrophy, don’t hesitate to consult with your doctor. This problem may be “natural” but it does not mean you have to live with these symptoms for the rest of your life.
How Is Vaginal Atrophy Different From a Yeast Infection?
While both of these conditions can have similar signs (dryness, redness, itching and even pain), they are caused by two different triggers. Yeast infections, as their name indicates, are caused by fungi overgrowth due to a number of circumstances (11). Vaginal atrophy or GSM, on the other hand, occurs due to the natural decline of hormones in the body after menopause. Thus, it’s not common in women under 50 (only 15% of women have symptoms of GSM during perimenopause (12).
If you have doubts about whether you’re suffering from either of these conditions, you should consult with your doctor to be sure. In the meantime, bear in mind that if you’ve already entered your perimenopause or menopause stages, these signs are strong indicators of vaginal atrophy rather than a yeast infection.
Final thoughts
Preventing vaginal atrophy is, unfortunately, not possible, as it’s a consequence of hormonal imbalance your body will inevitably experience during and after menopause. But identifying symptoms and getting help as early as possible can prevent vaginal atrophy from getting worse. The first step is to talk about this with your doctor so you can look for appropriate treatment together.
You don’t have to live with constant UTIs, burning and itching, or even pain for the rest of your life.
You have natural options available, like moisturizers and lubricants, that together with traditional solutions, will help you regain your sexual health and forget about vaginal atrophy for good.
TAKE THE MENOPAUSE ASSESSMENT
Learn where you are in your menopause / perimenopause journey with the help of a personalised report.
START ASSESSMENTREFERENCES
1. nhs.uk. 2021. Vaginal dryness. [online] Available at: <https://www.nhs.uk/conditions/vaginal-dryness/>
2. Moral, E., Delgado, J., Carmona, F., Caballero, B., Guillán, C., González, P., Suárez-Almarza, J., Velasco-Ortega, S. and Nieto, C., 2018. Genitourinary syndrome of menopause. Prevalence and quality of life in Spanish postmenopausal women. The GENISSE study. Climacteric, 21(2), pp.167-173.
3. Mayo Clinic. 2022. Vaginal atrophy - Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288#:~:text=Overview,leads%20to%20distressing%20urinary%20symptoms>
4. Bleibel B, Nguyen H. Vaginal Atrophy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK559297/
5. Faubion, S., Sood, R. and Kapoor, E., 2017. Genitourinary Syndrome of Menopause: Management Strategies for the Clinician. Mayo Clinic Proceedings, 92(12), pp.1842-1849.
6. Mayo Clinic. 2022. Vaginal atrophy - Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288#:~:text=During%20the%20years%20leading%20up,as%20some%20birth%20control%20pills>
7. Acog.org. 2022. Experiencing Vaginal Dryness? Here's What You Need to Know.. [online] Available at: <https://www.acog.org/womens-health/experts-and-stories/the-latest/experiencing-vaginal-dryness-heres-what-you-need-to-know>
8. Brotman, R., Shardell, M., Gajer, P., Fadrosh, D., Chang, K., Silver, M., Viscidi, R., Burke, A., Ravel, J. and Gravitt, P., 2014. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause, 21(5), pp.450-458.
9. Naumova, I. and Castelo-Branco, C., 2018. Current treatment options for postmenopausal vaginal atrophy. International Journal of Women's Health, Volume
10, pp.387-395.
10. Alvisi, S., Gava, G., Orsili, I., Giacomelli, G., Baldassarre, M., Seracchioli, R. and Meriggiola, M., 2019. Vaginal Health in Menopausal Women. Medicina, 55(10), p.615.
11. Cleveland Clinic. 2022. Vaginal Atrophy (Atrophic Vaginitis): Symptoms & Treatment. [online] Available at: <https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy#:~:text=What%27s%20the%20difference%20between%20vaginal,caused%20by%20a%20fungal%20infection>
12. Gandhi, J., Chen, A., Dagur, G., Suh, Y., Smith, N., Cali, B. and Khan, S., 2016. Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. American Journal of Obstetrics and Gynecology, 215(6), pp.704-711.
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