What Is Vaginal Atrophy? How to Treat Symptoms Like Dryness and Pain
The condition affects more than half of women in menopause
As our bodies undergo hormonal shifts during perimenopause and beyond, symptoms like hot flashes, sleep troubles and mood swings are expected. But what’s less discussed is the dryness, discomfort and pain during intimacy—often symptoms of vaginal atrophy.
Caused by decreased estrogen levels, this condition is more common than you’d think. In fact, it affects at least 50 percent of women going through menopause. The good news? There are plenty of easy and effective remedies for quick relief. Keep reading to explore the symptoms and treatments of vaginal atrophy to maintain your vaginal health.
What is vaginal atrophy?
Sometimes known as vulvovaginal atrophy or a genitourinary syndrome of menopause (GSM), vaginal atrophy refers to the thinning, drying and inflammation of the vaginal walls, explains Barbra Hanna, DO, FACOG, NCMP, board-certified ob-gyn and founder of MyMenopauseRx.
It can also affect the vulva, urinary tract and pelvic floor muscles, leading to various symptoms that can impact your quality of life, adds Louise Newson, BSc, MBChB, MRCP, FRCGP, a general practitioner and menopause specialist.
The most common vaginal atrophy symptoms include dryness, itchiness and intermittent or constant pain. Dr. Newson says some women may also experience more frequent episodes of cystitis, thrush or discomfort when sitting or walking.
Is vaginal atrophy a symptom of menopause?
While vaginal atrophy can occur at any time, it becomes more common leading up to perimenopause or menopause. Why? Estrogen levels experience a sharp decline, and other hormones, such as oestrogen and testosterone, will fluctuate.
Dr. Hanna explains that estrogen receptors are present in the vagina, vulva, bladder and urethra, and a sufficient estrogen supply is essential for keeping these tissues healthy. “Without estrogen, the vaginal pH begins to rise,” she says, ultimately leading to the aforementioned symptoms.
Worth noting: Vaginal atrophy can also appear in younger women, particularly those taking contraceptives or healing after pregnancy, says Dr. Newson. Without treatment, these symptoms usually persist for the long term and can sometimes worsen with age.
How to treat vaginal atrophy
With so many safe and effective options to treat vaginal atrophy, there’s no reason to prolong suffering. Dr Hanna says a good place to start is deciding whether you would like to ease your symptoms or reverse the atrophy by treating the underlying problem. Once you identify that, various natural and prescribed remedies can alleviate discomfort. These include:
Vaginal lubrication
Both vaginal moisturizers and lubricants help reduce vaginal atrophy symptoms. However, Dr. Newson believes a lubricant is more beneficial to help with dryness, specifically during sexual intercourse. “These treatments help by restoring moisture, improving skin elasticity and soothing irritation, which can be beneficial in relieving the symptoms associated with vaginal atrophy as well as improving urinary symptoms,” she says.
Sexual intercourse
Even though vaginal atrophy can sometimes cause pain during sex, regular sexual activity or gentle stimulation increases blood flow to the area, which can naturally help maintain tissue health and elasticity, says Dr. Hanna.
Vaginal estrogen
If you’re looking for a prescribed remedy that can help treat the underlying causes of vaginal atrophy, vaginal estrogen is a type of hormone treatment that is highly recommended. “Available as creams, vaginal tablets or rings, local vaginal estrogen directly improves thickness, elasticity and moisture,” says Dr. Hanna. She notes that topical estrogen and estrogen tablets are available in generic and cost-effective options.
Vaginal DHEA
Another helpful prescribed treatment is vaginal DHEA, also known as prasterone. It works to ease vaginal atrophy symptoms by improving moisture, vaginal pH and discomfort. For best results, apply the vaginal cream directly to the affected area, as it will locally convert into both estrogen and testosterone within the vaginal tissues, explains Dr. Newson. This should be used regularly or until the dryness and discomfort are reduced.
Ospemifene
“This is a specialized oral estrogen that selectively targets the vaginal tissues to improve atrophy, but does not bind to other estrogen receptors elsewhere in the body,” says Dr. Hanna, meaning It acts like estrogen in some tissues but blocks its effects in others to reduce symptoms. This type of estrogen treatment is especially beneficial for reducing vaginal dryness.
It’s worth noting that the vaginal atrophy treatment you choose will vary based on your symptoms. And Dr. Hanna suggests consulting with your doctor before starting any new prescriptions.
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