The vagina is the outer portion of the birthing canal that encloses the mouth of the uterus or the cervix. It is lined with mucous membranes and normally the female hormone estrogen helps to keep these inner walls moist and lubricated.
With age the levels of estrogen fall as the woman reaches the menopause. As the levels of estrogen drop, the inner walls of the vagina turn dry and the cells within it that keep it moist and stretchable become scant and atrophied. This condition is termed as vaginal atrophy or atrophic Vaginitis.
Causes of vaginal atrophy
Vaginal atrophy is most commonly seen after a women reaches menopause. At this time the ovaries reduce the secretion of estrogen. This makes the menstrual cycles become irregular, bleeding scanty and ultimately periods stop completely.
Estrogen levels fall when ovaries and/or uterus of a woman are removed surgically. This could be before a woman has achieved menopause and this surgery brings about an artificial menopause.
Breastfeeding mothers are also deficient of estrogen. This may lead to temporary vaginal atrophy. Once breastfeeding is completed the levels of estrogen return to normal and this causes the vaginal atrophy to reduce.
Certain medications that are used in the treatment of uterine fibroids and endometriosis also reduce the levels of estrogen and may cause vaginal dryness as a side effect.
Symptoms of vaginal atrophy
Symptoms of vaginal atrophy usually take time to appear after estrogen levels begin to decline. Some of the symptoms of vaginal atrophy include:-
Many women may not have any serious or specific symptoms of vaginal atrophy.
The vaginal secretions are lower and there may be itching and dry sensation.
Sometimes there may be a burning sensation within the vagina.
The vaginal walls become thinner and lose some of the folds that are normally present and that allow the walls to stretch.
There may be pain when anything is inserted into the vagina such as during sexual intercourse, sexual contact or masturbation.
There may be light bleeding or spotting after intercourse.
Treatment of vaginal atrophy
There are two basic approaches to treating vaginal atrophy:-
Relief of the symptoms of dryness
This can be done by using vaginal lubricants or vaginal moisturizers. These moisturizers are available without a prescription at most drug stores. These can be used as lotions, gels or suppositories. Vaginal lubricants are useful for women who experience vaginal dryness only during sexual intercourse.
Estrogen containing creams
Normalizing the levels of estrogen locally using estrogen containing creams over the vagina. These are available on prescription and may be applied locally or may be prescribed as pills or patches.
For women who have not had their wombs removed in a hysterectomy operation, the hormone progesterone is given along with estrogen. This is done to prevent the risk of getting womb or endometrial cancer.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)