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Vaginal tissue no longer functions normally, as the lining of the vagina begins to shrink/thin out
Also known as “Genital Syndrome of Menopause”
Often occurs in women during menopause due to the loss of estrogen
Can also occur in younger women who have a decrease in estrogen
PotentialCauses
Lower estrogen production as a result of menopause
The lining of the vagina can become thinner and less stretchy and the vaginal canal can narrow and shorten
Less estrogen lowers the amount of normal vaginal fluids and changes the acid balance of the vagina
Lower estrogen levels can also occur in women who have just given birth and are breastfeeding, have had their ovaries removed or are taking certain medications (aromatase inhibitors for breast cancer treatment)
Symptoms
Vaginal dryness
Vaginal burning
Vaginal discharge
Genital itching
Burning with urination
Urgency with urination
Frequent urination
Recurrent urinary tract infections (UTIs)
Urinary incontinence
Light bleeding after intercourse
Discomfort with intercourse
Decreased vaginal lubrication during sexual activity
Shortening and tightening of the vaginal canal
Diagnosis
Pelvic exam: Pelvic organs are felt and your external genitalia, vagina and cervix are visually examined
Urine test: To check for blood/abnormalities if you have urinary symptoms
Acid balance test: A sample of vaginal fluids is taken with a paper indicator strip to test its acid balance
Treatment
Lotions & Oils: Add moisture and loosen the vagina to improve comfort during sex
Moisturizers: For irritation and dryness similar to a skin moisturizer
Personal Lubricants: Best used to minimize friction and relieve vaginal dryness during intercourse
Not recommended to use Vaseline (can lead to yeast infections), olive/Vitamin E oil (can cause an allergic irritation in the vaginal area) or Mineral oil
Dilators: Devices to widen (dilate) the vagina to enable you to go back to having sex without pain
Hormone Therapy: Brings back the health of the skin by restoring the normal acid balance of the vagina, thickening the skin (back to how it was originally), maintaining natural moisture and improving bacterial balance
Dilators used in conjunction with local hormone therapy for best results
Vaginal Estrogen Therapy: Helps restore normal vaginal pH
Cream form: Estradiol/conjugated estrogens
Pill form: Inserted into the vagina
Ring form: Left in the vagina and replaced every 3 months
Vaginal Laser Therapy: To restore the function of the vaginal area
Can help with painful intercourse, dryness and laxity
Hormone Replacement Therapy (HRT)/Systemic Hormone Therapy: Taken orally in higher doses
For those who have additional menopausal symptoms
Ospemifene (Osphena): Non-estrogen pill that is taken orally
Its benefits to the vagina are similar to that of estrogen