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What Menopausal Women Need to Know About Vaginal Atrophy

The Relationship Between Menopause and Atrophy

Even in this day and age, many women are too embarrassed to talk about their menopause symptoms, even with friends and close family. Worryingly many women are too shy to discuss some more intimate issues with their doctor which can lead to unnecessary suffering.

Take vaginal atrophy, also known as atrophic vaginitis, for example. This is a common type of atrophy in menopausal women and is one of those conditions which can be distressing and even life-changing, but is rarely discussed openly.

In this article, I will focus on menopause and atrophy – particularly vaginal atrophy.

What Is Vaginal Atrophy?

Vaginal atrophy is when the vagina walls become thin, dry and possibly inflamed due to the loss of estrogen which is why it is often (but not always) associated with menopause when estrogen levels naturally drop.

According to the American Association of Family Physicians, up to 40 percent of post-menopausal women report that they suffer from atrophy. However, the true figure may be much higher as some women either believe it is a normal and unavoidable side effect of menopause or are too embarrassed to tell anyone about their symptoms and therefore suffer in silence.

The severity of symptoms can range from mild to severe, with some women experiencing slight discomfort while others endure pain, repeated urine infections and sexual problems.

What Are The Symptoms Of Vaginal Atrophy?

The earliest sign of vaginal atrophy is usually vaginal dryness. Other symptoms are many and varied and often are confused with other conditions. Vaginal atrophy can cause:

  • Redness and itching in the genital area.
  • Burning sensation in the vagina.
  • Discharge, often colored or smelly.
  • Burning sensation when urinating.
  • Urgency with urination.
  • Urinary incontinence.
  • Frequent water infections, or urinary tract infections (UTIs).
  • Painful intercourse and/or decreased lubrication during sexual activity.
  • Bleeding or discomfort after intercourse.
  • Tightening and shortening of the vaginal canal.
  • Pelvic organ prolapse where you have bulges in the vagina wall.

Physical signs may include having a pale, smooth vaginal lining (use a mirror or ask your partner to check), a loss of elasticity, sparse pubic hair and smooth, thin external genitals

It’s important if you develop any of these symptoms to book an appointment to be checked by a doctor. It may involve a vaginal exam or inspection of the genital area, a smear and possibly blood and urine tests.

This might sound daunting, but it’s vital to be brave, book an appointment with an OBGYN and tolerate a small amount of embarrassment as some of these symptoms can also be caused by potentially life-threatening conditions, most of which will respond better to treatment if identified early.

Many free clinics in the US will be able to arrange this kind of exam so don’t let worry about the cost or lack of insurance stop you from getting checked. You can take someone along with you or ask for a chaperone if you have any concerns about being alone with the person doing such an intimate exam.

I Have Vaginal Atrophy, Now What?

Often using vaginal lubricant and/or moisturizers will be all that’s required to bring everything back to normal working order. These can be purchased cheaply at the drug store or the supermarket. It’s wise to use products specifically designed for this sensitive area as others, even if marketed for sensitive skin, may make the problem worse.

Be aware if using lubricants that some (mostly oil-based lubricants) affect the efficiency of condoms and could result in an unexpected pregnancy. You might be going through the menopause, but you can get pregnant even if it’s been months since your last period. Damaged condoms might also not protect you against sexually transmitted diseases so be sure to buy water based lubricants which state they are “condom-friendly.”

If using moisturizers and lubricants isn’t enough there are a number of treatments for vaginal atrophy.

Since atrophy is frequently caused by diminished estrogen, it is often successfully treated by hormone replacement therapy. This can be in tablet or patch form but is often more effective in treating atrophy if applied directly to the vagina and genital area in cream, gel, ointment, ring or pessary form.

Topical application also has the benefit of limiting the absorption of hormones throughout the body, cutting down on the strength of hormone needed and the potential for side effects. However topical estrogen does not generally help control or reduce other menopause symptoms like hot flashes or protect against osteoporosis in the way oral hormone therapy can. Take advice from your doctor about the best route for you.

Women with atrophy are at greater risk of developing vaginal infections, atrophy in the urethra (where your urine comes out) and incontinence so it’s worth getting help before the situation worsens and the condition is harder to get under control.

I Don’t Have Vaginal Atrophy… Yet! Can I Prevent It Developing?

The great news is that yes, there are ways to minimize the risk of atrophy during menopause. Believe it or not, regular sex or masturbation leading to orgasm can help keep your vagina healthy, lubricated and prevent it from shortening and narrowing.