Vaginal Atrophy

>> Tuesday, June 25, 2013

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Today I think we need to talk about vaginal atrophy, also called atrophic vaginitis, which I know most of you have never heard of. What happens with vaginal atrophy is that the vaginal walls begin thinning and drying out, which causes inflammation. It is due to your body having less estrogen as well as other hormone changes. Hormone changes can occur for many reasons as our bodies age or go through illness or disease.

The most common cause of vaginal atrophy is menopause, but it can also develop during breast-feeding or at any other time your body's estrogen production declines. It can make sex very painful — and if sex hurts, our interest & desire for sex will decrease. Luckily, effective treatments for vaginal atrophy are available, so it can be reversed.

Painful sex (dysparunea - wow, what a name!) is only one of the problems that lack of estrogen and vaginal atrophy causes. Women can also experience vaginal burning, vaginal discharge or extreme vaginal dryness (from lack of discharge), genital itching, not making it to the bathroom on time (whether from urine or your bowels), more urinary tract infections, light bleeding after sex, decreased vaginal lubrication during sexual activity, shortening and tightening of the vaginal canal.

So what's the deal anyway? What is the cause of all these changes? As if we need one more thing to change in our womanly bodies! It has to do with hormone changes, especially estrogen. Remember we have 3 main hormones that are produced by our ovaries; estrogen, progesterone, and testosterone. Hormone changes can occur after menopause, during the years leading up to menopause (called perimenopause), after giving birth and during breast-feeding, after surgical removal of both ovaries or as a side effect of any cancer treatment that requires chemotherapy or radiation.

In addition to hormone changes, habits like cigarette smoking affect your blood circulation, resulting in the vagina and other tissues not getting enough oxygen. So smoking can also reduce the effects of naturally occurring estrogens in your body no matter how old or young you are. In addition, women who smoke typically experience an earlier menopause.

Women who have given birth through c-section and have never given birth vaginally are more likely to develop vaginal atrophy than women who have had vaginal deliveries - possibly due to the effects that the stretching has on the function of the vaginal muscles. It is also known that women who remain sexually active with or without a partner have less trouble with vaginal atrophy as sexual activity and orgasm increases blood flow and makes your tissues more stretchy and elastic.

Lack of estrogen and hormone imbalance causing vaginal atrophy increases your risk of vaginal infections and urinary problems like bladder prolapse (falling out) and incontinence. It can also cause changes to the acid balance of your vagina, making you more likely to get a vaginal infection (vaginitis), and feel constant irritation and burning.

When you have your annual exam with your gynecologist, is easy to tell if this is what is going on, as the vaginal tissues are pale and lack ability to stretch - which makes the pelvic exam painful. It is also easy to see if you have signs of pelvic organ prolapse — indicated by bulges in your vaginal walls as your bladder or rectum try to fall out through the vaginal vault. Or, the cervix may be sitting much lower at the vaginal opening instead of at the top of the vagina.

To treat vaginal atrophy you can try vaginal moisturizers to restore some moisture to your vaginal area or use lubricants during sex. Use a water-based lubricant and try to avoid petroleum jelly or other petroleum-based products, especially if you're using condoms. Petroleum can break down latex condoms on contact. Petroleum will also coat the vagina and can cause yeast and bacteria to cling to the vaginal walls and cause more infections and irritation.

There are also prescription vaginal estrogen treatments which come in cream or tablet forms and will directly restore and nourish the vaginal tissues. Because menopause and hormone imbalance with lack of estrogen is associated with other symptoms such as moderate or severe hot flashes, night sweats, muscle aches and pains, fatigue, brain fog, trouble sleeping, and moodiness, most women choose to take natural estrogen pills, patches or topical creams and gels. These will treat the vaginal atrophy and help with all these other symptoms.

So, if you are experiencing vaginal atrophy symptoms, go see your doctor, as there is so much that can help it.

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