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Postmenopausal and Dry ‘Down There’? It May Be Vulvovaginal Atrophy

When we talk about menopause, it’s pretty common to discuss related issues such as hot flashes, insomnia, and irritability. But if you’re anything like us, vulvovaginal atrophy — which refers to thin, dry vaginal and vulvar tissues — probably isn’t part of your conversations at all. However, recent research shows that this pesky problem is a lot more common than you might think. Experts have estimated that it can affect up to 98 percent of all postmenopausal women, with about 50 percent of those folks experiencing vaginal dryness. Since this problem can lead to an impaired quality of life, it’s crucial that you address it with your doctor if you have it sooner rather than later. That way, you can get the proper treatment you need.

Back in June 2018, a study published in Climacteric found that vulvovaginal atrophy is highly prevalent among postmenopausal women and that it can lead to serious problems if left untreated. In the study, researchers looked at 2,160 women aged 45 to 75 years old. If a participant reported at least one symptom of vulvovaginal atrophy, they went to a gynecological examination to see if they had it or not. As it turned out, vulvovaginal atrophy was confirmed in a whopping 90 percent of the patients studied — and the folks with the condition had much more severe symptoms and lower quality of life than those who didn’t have it.

In November 2018, researchers conducted a much closer analysis of the survey, focusing on the association between vulvovaginal atrophy and overall quality of life. The resulting article, published in Menopause, the journal of The North American Menopause Society (NAMS), found that severe vulvovaginal atrophy symptoms have a direct link with worsened quality of life for postmenopausal women. The researchers suggested that healthcare providers should recognize the effects of this condition just as much as other health issues that get more widespread attention.

“Although both women and their healthcare providers are often reluctant to talk about it, vaginal atrophy (part of the genitourinary syndrome of menopause) affects quality of life, self-esteem, and the intimacy of relationships,” said JoAnn Pinkerton, MD, executive director of NAMS, in a press release. “The good news is that there are over-the-counter therapies, such as lubricants and vaginal moisturizers, as well as local vaginal prescription therapies that can relieve both vaginal dryness and painful sex and improve the quality of life for women.”

But why is this issue so common for women in this particular age group in the first place? Well, according to the Cleveland Clinic, vulvovaginal atrophy usually happens during menopause because women start to lose the hormone estrogen at that time, which leads to shrinking and thinning of the vaginal walls. And then come the associated symptoms, which can be pretty darn unbearable.

Signs of Vulvovaginal Atrophy

While the feeling of being dry “down there” is obviously an annoying and uncomfortable symptom, this dryness is also associated with much more severe issues. These problems can include irritation, soreness, painful sexual intercourse, urinary frequency, and incontinence. According to the Mayo Clinic, some other issues that can arise during vulvovaginal atrophy include vaginal burning, itching, discharge, and the possibility of more urinary tract infections. As you can imagine, these problems have the potential to interfere with your day-to-day life — and no one deserves that. But wait: If so many women are going through this horrendous problem, why don’t we ever hear about it? Experts offered a couple guesses after the survey results came out.

“The study called for ‘appropriate clinical assessment and early therapeutic intervention,’ which can be tricky because providers fail to ask about it and many women don’t discuss their symptoms because either they don’t know about VVA or are too embarrassed to discuss their symptoms,” said Mary Jane Minkin, MD, FACOG, clinical professor of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine, in a press release. “And that’s a shame because there are effective treatments available, from hormone therapies to over-the-counter hormone-free solutions, depending on personal preferences, needs, understanding of potential risks, and consultation with a health provider.”

How to Treat Vulvovaginal Atrophy

According to the North American Menopause Society, the “first-line therapies” for vulvovaginal atrophy should ideally be the regular use of long-acting vaginal moisturizers and non-hormonal vaginal lubricants for intercourse. Dr. Minkin suggested that in some cases, a quick trip to the pharmacy for Replens could potentially be enough to solve the problem.

“Replens changes the water content and moisturizes vaginal tissues, making them more elastic, thicker, and with enhanced ability to maintain fluid,” Minkin said. “It lasts for three days and can do much as a first-line therapy to enhance postmenopausal women’s quality of life in a safe and effective way.”

That said, it’s worth keeping in mind that some women might need hormone therapies or other forms of treatment, depending on what kind of specific symptoms they have and how severe the issues are. For instance, laser therapy may be helpful for some women who need alternative treatments, according to Harvard Medical School. If you suspect that you might have vulvovaginal atrophy, talk to your doctor about the best options for you.

You deserve to feel healthy and happy — everywhere on your body!

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