Menopause and the Vaginal Health

What is vaginal atrophy?

Menopause is a natural phase in life that occurs to every woman.  During the menopausal transition, the body goes through several changes causing uncomfortable and challenging symptoms such as hot flashes, insomnia, mood swings and a common, but unknown condition to many women, called vaginal atrophy.
  
Vaginal atrophy (or atrophic vaginitis) is a natural condition experienced by many postmenopausal women. Vaginal atrophy involves the thinning and inflammation of the vaginal walls, the loss of elasticity and moisture of the vaginal tissues, and the shortening and narrowing of the vagina.  As well as changes in the normal levels of the vaginal pH which can leave the vagina unprotected from bacteria, therefore more susceptible for urinary tract infections. Vaginal atrophy is sometimes referred by women as “vaginal dryness”, yet “vaginal dryness” is only one of the many symptoms of vaginal atrophy. 

For more information on menopause and symptoms like hot flashes, insomnia and mood swings go to the section “Menopause”.

What causes vaginal atrophy?

During the menopausal transition, the ovaries, which produce estrogen during the child-bearing years,  slowly transition from producing estrogen regularly to producing very little or no estrogen at all (menopause).

Estrogen is a hormone that plays an important role in the vaginal and sexual health, among its various functions in the body. Estrogen is responsible for maintaining the structure of the vaginal walls, maintaining the elasticity, humidification and blood circulation of the vaginal tissues, and regulating the vaginal pH to normal levels reducing the risk of urinary tract infections.  

What are the symptoms of vaginal atrophy?

Vaginal atrophy leads to distressing symptoms which may adversely affect a woman’s quality of life. Different from vasomotor symptoms, vaginal atrophy symptoms progress and worsen with time unless treated.[1] The most common symptoms of vaginal atrophy include:

·         Vaginal dryness
·         Pain during sexual intercourse
·         Burning and itching in and around the vagina
·         Vaginal irritation or soreness
 
For more information on vaginal dryness, go to the “Vaginal Dryness” section

Other symptoms such as urogenital and sexual symptoms may also be associated to vaginal atrophy.  These symptoms are:

·         Loss of libido or sexual interest
·         Urgency to urinate
·         Urinary incontinence (leaking)
·         Frequent urinary tract infections

Studies report that 40 to 60% of women develop vaginal dryness during the menopausal transition, but only 1 in 4 women will go to their doctor to discuss their symptoms and seek treatment.[2] [3] Talk to your doctor if you have experienced 1 or more of these symptoms, even if you think the symptom(s) is not related to vaginal atrophy.  

What are my treatment options?

Every woman will eventually reach menopause and will experience the symptoms of vaginal atrophy to some degree. This, however, does not mean that women have to live with the uncomfortable symptoms of vaginal atrophy for the rest of their life as there are effective treatment options available in Canada.

Effective treatment options for vaginal atrophy typically consist of low-dose local estrogen therapy.For those who have contraindications to hormones or prefer not taking them, there are non-hormonal treatments that can relieve certain symptoms of vaginal atrophy (mainly vaginal dryness and pain during sexual intercourse). Non-hormonal treatments available in Canada mainly consist of moisturizers and lubricants.

Talk to your doctor to see which treatment option is right for you.

For more information on vaginal dryness go to the “Vaginal Dryness” section.

How can I improve my vaginal health?[1]

In addition to using treatments for the relief of vaginal atrophy symptoms, there are other things you can do to help maintain your vaginal health:

Maintain regular sexual activity:It is important to maintain a healthy emotional and physical relationship with your partner. Staying sexually active has demonstrated to maintain vaginal elasticity and improve the blood flow to the vagina. This will help in maintaining your vaginal tissues lubricated and healthy.

Minimize possible irritation to the vagina:

• Wash clothing with non-perfumed or low-allergenic products and avoid the use of fabric softeners.
• Gently wash the skin of the genital area with plain water or with a gentle soap. Always pat dry your genital area (do not rub). 
• Avoid the use of feminine hygiene sprays and douches; as well as pads, tampons and toilet paper that are scented.
• Wear underpants made of natural fibres such as cotton or consider using no undergarments when possible (ex. when going to bed).

 If you smoke, quit smoking: Smoking increase vaginal atrophy by decreasing blood flow to the vagina, as well as threatening your overall health. Ask your doctor for programs that can help you quit smoking.