Vaginal Atrophy
What is vaginal atrophy?
Vaginal atrophy is when the walls of the vagina become thin, dry, and inflamed. It occurs most frequently by the drop in estrogen levels after menopause. According to the Mayo Clinic, women’s estrogen levels drop by 85% after menopause. It is also referred to as genitourinary syndrome of menopause (GSM).
What are the symptoms of vaginal atrophy?
Image Credit: https://medlineplus.gov/ency/imagepages/19925.htm
You may experience symptoms in your vagina as well as the urinary tract. Symptoms include:
• Vaginal dryness or burning
• Genital itching
• Unusual vaginal discharge
• More yeast infections
• Burning when urinating
• A need to urinate more frequently
• Incontinence (a harder time holding your urine)
• More urinary tract infections (UTIs)
• Discomfort or bleeding during sexual intercourse
• Less natural lubrication during sexual intercourse
• Shortening and tightening of the vaginal canal
Approximately 40% of women will experience GSM symptoms with dryness usually being the first sign. These symptoms may arise during perimenopause, the
months or years leading up to menopause, as well as after you have reached menopause.
What causes vaginal atrophy?
Genitourinary syndrome of menopause is caused by a decrease in estrogen production. Less estrogen causes vaginal tissues to become thinner, drier, less
elastic, and more fragile. A drop in estrogen may occur:
• After menopause
• Perimenopause
• After surgical removal of both ovaries (surgical menopause)
• During breast-feeding
• While taking medications that can affect estrogen levels
• After pelvic radiation therapy for cancer
• After chemotherapy for cancer
• As a side effect of breast cancer hormonal treatment
These symptoms may arise during perimenopause, menopause, or years after entering menopause. Regular sexual activity, with or without a partner, can help maintain healthy vaginal tissues.
What are the risk factors for vaginal atrophy?
Certain factors may contribute to GSM other than just menopause, such as:
• Smoking – Cigarette smoking affects blood circulation and may lessen the flow of blood and oxygen to the vagina and other nearby areas. Smoking also reduces the effects of naturally occurring estrogens in the body.
• No vaginal births – Research has shown that women that have never given birth vaginally are more likely to develop GSM symptoms.
• No sexual activity – Sexual activity, with or without a partner, increases blood flow and makes vaginal tissues more elastic.
What are the complications of vaginal atrophy?
Vaginal atrophy, or GSM, increases your risk of the following:
• Vaginal infections – Changes in the acid balance of your vagina make vaginal infections more likely
• Urinary problems – Urinary changes associated with GSM can contribute to urinary problems. You may experience increased frequency or urgency of urination or burning with urination. Some women may experience more urinary tract infections or urine leakage (incontinence).
What treatment options are available at Compounding Solutions Pharmacy & Wellness?
Fortunately, there are a multitude of treatment options for vaginal atrophy. At Compounding Solutions Pharmacy & Wellness, we offer hormonal and non-hormonal
treatment options as well as multiple dosage forms to suit anyone’s needs.
Hormonal treatments
• Vaginal estrogens (estradiol or estriol) – By using estrogen vaginally, the systemic absorption is minimal and allows the hormones to locally treat the symptoms of vaginal atrophy. Research has shown effectiveness of vaginal estrogen at relieving dryness, pain/discomfort during sex, and itching. Vaginal estradiol or estriol
is available as a cream or a minisert, a small, dissolvable vaginal tablet.
• Vaginal DHEA miniserts – DHEA, or Dehydroepiandrosterone, is a precursor for many other hormones in the body. In cells it can be converted to testosterone or estrogens. Miniserts are small, dissolvable vaginal tablets.
• Topical hormones or oral hormone combinations – Oral and topical hormones can be used to treat vaginal atrophy as well. Topical creams are typically applied to the wrist, inner thigh, or other non-hairy areas of the body. Systemic formulations can also help with other menopausal symptoms that you may be experiencing.
Non-hormonal treatments
There are also non-hormonal treatments available for women that do not want to add any hormones or for those who cannot, such as those undergoing cancer treatment.
• Vitamin E vaginal suppositories or cream – Research has shown that vitamin E used vaginally can improve vaginal lubrication and symptoms of vaginal atrophy
• Hyaluronic acid/Vitamin A/Vitamin E vaginal suppositories – Hyaluronic acid is a moisturizer that is typically associated with skin care products. However, when used vaginally, it can help to improve vaginal lubrication.
For more information on menopause or menopause treatment options, please click the appropriate button below.
What over-the-counter options are available?
• Vaginal moisturizers – Vaginal moisturizers, such as Replens, may help restore moisture to the vaginal area. You may have to apply moisturizer every few days, but the effects of a moisturizer typically lasts longer than lubricants.
• Water-based lubricants – Water-based lubricants, like Astroglide or KY Jelly, are typically applied prior to sexual intercourse and may reduce any discomfort during intercourse.
Sources:
https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288#:~:text=Overview,leads%20to%20distressing%20urinary%20symptoms.
https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy
https://www.webmd.com/menopause/vaginal-atrophy
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074805/
https://www.healthline.com/nutrition/vitamins-to-increase-female-lubrication#4.-Hyaluronic-acid
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5114791/