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Vaginal Dryness PDF Print
Written by Editors, Red Hot Mamas   
Friday, 18 May 2007 05:15
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0.1. What exactly is going on down there?
0.2. What can go wrong?
0.3. What can you do about it?

You are aging and your V-Zone is changing. Things are becoming a little drier, itchier and more easily irritated. Does this happen to everyone? Do you have vaginal atrophy? It is possible to have vaginal atrophy and not experience symptoms but many women with moderate to severe cases usually experience them.

As a matter of fact, an estimated 10% to 40% of postmenopausal women have symptoms related to vaginal atrophy. Symptoms can include vaginal dryness, burning, discharge, burning with urination, urgency with urination, more urinary tract infections, urinary incontinence, light bleeding after intercourse and/or discomfort with intercourse.Your vagina may feel smaller, shorter or narrower.Unlike other menopause symptoms like hot flashes, vaginal atrophy problems usually don’t subside over time.

Most cases require treatment but unfortunately, only 25% of women with symptoms seek medical help. Why suffer with this condition if it greatly compromises your quality of life? The North American Menopause Society dishes out some important viable options for women to treat their vaginal atrophy. Understanding the causes of your problems will help you treat them more effectively.

0.1. What exactly is going on down there?

Like everything else during menopause, it's commonly associated with your declining estrogen levels. Vaginal walls may become thin, pale, dry and sometimes inflamed when one has vaginal atrophy. Many women experience a drying-up effect because blood doesn't flow as easily to that area of the body. As a result, relying on your body to naturally lubricate during sexual activity can become a very frustrating experience.

There can be other causes of vaginal atrophy as well. Cancer treatments can cause the condition including Chemotherapy, which can induce menopause early and is commonly the cause of sexual dysfunction. Similar symptoms of vaginal atrophy can also be caused by infection, trauma, foreign body, allergic reaction, inflammatory conditions of the vulva, benign and malignant tumors, other medical disorders (i.e., diabetes, lupus) and psychological causes.All the more reason to talk to your doctor!

0.2. What can go wrong?

Atrophy causes a shift in the acidity of your vagina that can make you more susceptible to infection (a condition called vaginitis).As the lining of the vagina thins, you are at a greater risk of developing sores or cracks in the walls that can result in recurrent vaginal infections.

Urinary tract infections and incontinence can develop which can lead to painful, burning while urinating.Other urinary problems are also associated with vaginal atrophy including a condition called genitourinary atrophy (changes in the urinary system and function). 

When you visit your healthcare professional, they will ask questions about your symptoms and probably assess your hormone levels.You will probably have a pelvic exam so your doctor can check the physical condition of your vagina.Many times, a sample of the cells from your vagina are taken and looked at under a microscope.Also, they may test the acidity of the vagina with a paper indicator strip. 

0.3. What can you do about it?

Yes, it is manageable.Talk with your doctor about personalizing therapies to meet your needs.Go see your doctor if you experience painful intercourse that is not resolved by using an appropriate vaginal moisturizer (Liquibeads, Replens, etc.) or water-based lubricant (Astroglide, K-Y, others). If none of these interventions help, other treatment options are available.

Since the condition of vaginal atrophy is caused by a lack of hormones, the next line of treatment is to supplement that hormone.Prescription treatments usually involve some type of hormone therapy.

Estrogen can be delivered through the body systemically or locally.However, systemic estrogen therapy (i.e., oral, transdermal) may not unacceptable to some women because of its potential for adverse effects (especially associated with long-term use).For these women, estrogen products that can be applied locally to the vagina are available.

Vaginal estrogen options

Various types of vaginal estrogens are available for the treatment of vaginal atrophy. These low-dose products can improve vaginal atrophy symptoms but they have no effect on reducing those hot flashes or lowering the risk of osteoporosis.

Overall, symptoms improved for 80%-90% of women treated with vaginal estrogen. Results usually happen quickly too.Symptoms typically improve within a few weeks of starting vaginal estrogen although some women may need to use it for 4 to 6 weeks.

Vaginal estrogen therapy products that are government approved for treatment of vaginal atrophy in the United States and Canada include:

  • Vaginal Creams:Estrace Vaginal Cream (Estradiol), Premarin Vaginal Cream (Conjugated Estrogens)
  • Vaginal Rings:Estring (Estradiol), Femring (Estradiol Acetate)
  • Vaginal Tablets:Vagifem (Estradiol Hemihydrate)

What type should you use? Creams, rings and tablets are all effective products that can provide great relief. Creams are usually given for 3 weeks of daily use followed by twice-weekly thereafter.It works by rubbing a small amount onto the affected area. Creams may offer more immediate comfort than rings and tablets but some women find them to be messy.

The vaginal estrogen ring is a small, soft flexible ring that is inserted into the upper part of the vagina.It needs to be replaced every ninety days by you or your doctor.The ring stays in place during sexual activity but some women complain about discomfort with tampon use.

Vaginal tablets are administered using a disposable applicator into the vagina.It is usually used twice a week.Ask your doctor which method is the best for your symptoms.

Learn more about the Red Hot Mamas approach to Hormone Therapy

No two women are alike, so the symptoms associated with menopause vary from woman to woman. To some, symptoms may only be a minor concern, while for others, they may disrupt everyday activities. Use the following Symptom Questionnaire to better prepare you to talk to your doctor about menopause symptoms.
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References:

"The Role of Local Vaginal Estrogen for Treatment of Vaginal Atrophy in Postmenopausal Women: 2007 Position Statement of the North American Menopause Society" Menopause:The Journal of the North American Menopause Society, Vol. 14, No. 3, pp. 370-371.

"Vaginal Atrophy" The Mayo Clinic, 6 Sept. 2006, retrieved 16 May 2007 from http://www.mayoclinic.com/health/vaginal-atrophy/DS00770

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Last Updated on Wednesday, 16 June 2010 14:14