Vaginal atrophy - also referred to as atrophic vaginitis - is when the tissues of the vaginal walls become dryer and thinner due to a decrease in the production of estrogen.

Although a drop in estrogen is normal for women during perimenopause and menopause, it does not have to lower your quality of life forever. Keep reading to learn more about vaginal atrophy, its symptoms, and the simple treatment options and home remedies for vaginal atrophy available to help you feel like your best self again.  

What Causes Vaginal Atrophy?

According to female health experts, the most common cause of vaginal atrophy is a drop in estrogen during perimenopause and menopause. The average age for American women entering menopause is estimated at 51, however, it is also known to happen earlier or later. 

As the ovaries produce less estrogen, it triggers various symptoms associated with menopause, including mood changes, hot flashes, night sweats, interrupted sleep, and weight gain, as well as a thinning of the skin. The drop in estrogen also lowers the production of natural lubrication in the vagina, meaning the vaginal skin is not only thinner and less elastic during menopause but dryer too.  

Younger women can experience a drop in estrogen while breastfeeding, but although vaginal atrophy can happen during this time, it is typically milder and temporary. However, if a younger woman has her ovaries removed, vaginal dryness could present as a symptom of early menopause. 

Additional factors that can lead to vaginal atrophy include fragranced detergents or soaps that irritate the vaginal skin, douching, chemotherapy, depression, stress, and untreated diabetes. Medication or hormone treatments for endometriosis, fibroids, infertility and breast cancer can also result in lower estrogen levels that cause atrophic vaginitis.

Vaginal Atrophy: Symptoms

While symptoms associated with vaginal atrophy will be limited to a sensation of vaginal dryness for some women, for many others, symptoms can also include urinary issues. Below is a full list of all symptoms known to be associated with vaginal atrophy. However, bear in mind that not all women will experience all symptoms. 

  • Vaginal dryness
  • Feeling of tightness in the vaginal canal
  • Painful intercourse (dyspareunia)
  • Light bleeding after sex
  • Less pubic hair
  • Thinning of the vulva & labia
  • Genital itching
  • Yellow or grey vaginal discharge
  • Vaginal irritation while riding a bike
  • Vaginal irritation when wearing tight pants 
  • Burning feeling when urinating
  • More frequent urge to urinate
  • Urinary incontinence
  • Recurring urinary tract infections (UTIs)

How Is Vaginal Atrophy Diagnosed?

Should you notice one or more of the above-mentioned symptoms, schedule a consultation with your doctor to speak about the possibility of vaginal atrophy. After a few questions to rule out the possibility of irritating soaps or detergents, your doctor will likely carry out a vaginal examination and possibly do a vaginal pH test to rule out any underlying infections.

That said, vaginal atrophy often renders the genitals more susceptible to infections so you might find that a vaginal infection like a UTI, yeast infection or bacterial vaginosis has set in due to atrophy. In this case, your doctor will prescribe medication to treat the infection, as well as treatment for vaginal dryness. 

Unfortunately, a vaginal examination can be uncomfortable for someone suffering from vaginal atrophy, but it is a short procedure and necessary to receive a correct diagnosis and the proper treatment.  

Vaginal Atrophy: Treatment Options

If painful sex (dyspareunia) is your only symptom, try using a water-based lubricant during sex. If there is no improvement, further treatment options, like those mentioned below, will be required. 

Hormone Replacement Therapy

Hormone replacement therapy (HRT) in the form of gel, implant, patch, or pill essentially replaces the estrogen that is lost during menopause. However, while HRT is considered effective in treating hormonal imbalances, women are advised to discuss the full list of side effects with their healthcare practitioner before committing to it as a long-term treatment option. 

Vaginal Dilator Therapy

Vaginal dilator therapy, which is typically used to treat anxiety and pain surrounding vaginal penetration during intercourse, is a natural way of treating vaginal atrophy. With guidance from a pelvic floor physical therapist, patients use a medically approved set of dilators of incrementally increasing sizes to gently stretch the vaginal tissues and gradually improve muscle elasticity. 

This gentle stretching of the vaginal tissues helps to reverse vaginal dryness and reignite sexual pleasure after menopause by increasing blood flow to the vaginal muscles and improving natural lubrication. 

Moisturize & Exercise

In addition to whichever therapy rings true for you, moisturizing and exercising also helps to rejuvenate dry vaginas post menopause. Our organic Enchanted Rose Natural Vaginal Moisturizer is perfect to soothe irritated or dry skin associated with vaginal atrophy. And regular exercise helps to increase blood circulation healthy in the genital area.

Preventing Vaginal Atrophy 

Engaging in regular sexual activity during perimenopause and menopause, either with yourself or someone else, is the best way to prevent vaginal atrophy. This is because sexual arousal increases the blood flow to the genitals, which in turn keeps the vaginal tissues healthy. 

Using a vaginal estrogen gel during perimenopause, before estrogen levels drop too much, also works for some. For those who prefer the natural route in managing fluctuating hormones, a daily Chasteberry supplement is known to mimic the effects of estrogen on the body and substantially reduce menopause symptoms such as vaginal atrophy, mood swings, & hot flashes. 

Conclusion

Approximately 10-40% of American women are known to experience symptoms of atrophic vaginitis during menopause, but many are too embarrassed to speak about it, and only 20-25% seek treatment. If you are experiencing any of the above-mentioned symptoms, don’t be nervous to speak openly with your doctor about treatment options.  

References 

Mayo Clinic - Vaginal Atrophy - https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288

Wiley Online Library - Resistance and Barriers to Local Estrogen Therapy in Women with Atrophic Vaginitis - https://onlinelibrary.wiley.com/doi/full/10.1111/jsm.12120

Endocrine Society – Menopause - https://www.endocrine.org/patient-engagement/endocrine-library/menopause

National Library of Medicine - Vulvovaginal Atrophy -  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800285/

American Family Physician - Diagnosis and Treatment of Atrophic Vaginitis - https://www.aafp.org/pubs/afp/issues/2000/0515/p3090.html

The Pelvic Hub – Why Use Dilators for Atrophy - https://www.thepelvichub.com/ask-the-experts/dilators-for-atrophy

The Pelvic Hub – Best Vaginal Dilators - https://www.thepelvichub.com/post/best-vaginal-dilators

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