In this educational article covering more details about vaginal atrophy, we touch on the symptoms, prevention, treatment, and management options for this condition. Vaginal atrophy is the tightening of the vaginal tissues, loss of natural moisture and pliability, and can cause significant amounts of pain.
How Vaginal Atrophy is Diagnosed
Your doctor or gynecologist can diagnose your atrophy suspicions based on the history and symptoms you provide and the findings of their physical examination. Some of the common signs of vaginal atrophy are:
- Minor lacerations or wounds near the vaginal opening
- Urethral lesions or cysts
- A prolapsing or drooping bladder
- Vulvar skin conditions, wounds, lesions, or rough patches
- Bulging at the back of the vagina
- Lack of or sparsity of pubic hair
- Discoloration of the vagina, sometimes with pale or whiteish coloring
- Shortened, narrowed vagina
- Loss of pliability or stretch with tissues
- Redness or swelling
- Varying levels of dryness from mild to extremely severe
Vaginal Atrophy Causes
Throughout a woman’s life, estrogen ebbs and flows, and eventually begins to permanently wane, making less than in the pubescent or childbearing years. With less estrogen coursing through the body, the lining of the vagina becomes thinner, eventually hardening, which also leads to a shortening of the vaginal canal. These circumstances also create very dry, very painful tissues, which is typically when people first reach out for help.
Medical Tests for Diagnoses of Vaginal Atrophy
For many women, a simple physical examination is enough to diagnose. In other cases, where multiple conditions or other issues make diagnoses difficult, these tests could be ordered by your doctor:
- Urine sample
- Pap smear
- Ultrasound
- Serum hormone testing
- Vaginal pH
- Microscopy (NIH)
Your medical care provider may also ask you questions like these:
- Are you in menopause?
- What medications are you taking?
- What supplements are you taking?
- Have you recently had a pregnancy or birth?
- Is vaginal intercourse painful?
- Do you use over-the-counter lubrications or moisturizers?
- Have you noticed any discharge? Unusual or regular?
- Have you had any bleeding or spotting?
- How long have you been experiencing these symptoms?
Most gynecologists and urologists have reported that they feel vaginal atrophy is underdiagnosed and encourage people to speak up to their healthcare providers whenever anything seems different or has changed (CDC).
Is Vaginal Atrophy Preventable?
Unfortunately, this type of atrophy is not preventable due to the body’s ability to change the levels of estrogen and ultimately the decrease of production of this hormone. While unpreventable, there are things that can be done to help keep the condition from worsening further. Beginning with avoiding panty liners, tight-fitting clothing, perineal pads, or any of these items that have been linked to vaginal irritation:
- Powders
- Perfumes
- Douches
- Deodorants
- Spermicides
- Lubricants
- Tampons
- Condoms (made from certain materials)
The Management of Vaginal Atrophy
After diagnosis, you will be given options for treatment plans which you and your doctor can discuss. Many individuals begin with a more natural, holistic approach using natural daily moisturizers and lubrications, along with beginning dilator therapy. For others, using estrogen therapy or surgical intervention are better options. Some treatment options treat only the symptoms and side effects, while others help to level the loss of estrogen.
- Lubrication and Moisturizers. These work to help to add moisture to the vagina and vulva areas. Vaginal dryness can be extremely painful and inhibit the person to be able to be intimate with themselves or with a partner. The user should look for a high-quality lubrication without fillers, additives, or extra chemicals. Reclaiming Intimacy offers a variety of water-based lubrication like System Jo H20, and silicone-hybrid aloe-based lubrications like Sliquid’s Satin. There are certain things that should not be used in the vagina like Vaseline, which can lead to yeast infections. Or olive oil and coconut oil, as these can cause an allergic reaction and irritation in the vaginal canal. Many vagina owners use these as they are touted as a “natural” product, but these are oils that are unnatural to the body and can be an allergen (sometimes unknown until it’s too late) for many. Sliquid offers a daily moisturize that uses seaweed and natural properties to help to restore natural moisture (CDC/NIH).
- Dilators. The probe-like devices are designed to be inserted into the vagina to help to widen the vagina for more comfortable penetration, insertion, and gynecologic exams. This therapy is done routinely each week, to help open the vagina over time. Intimate Rose offers high quality dilator sets for vaginal and anal dilation to get you started on your dilator therapy journey (CDC/NIH).
- Hormone Therapy. This therapy is designed to improve symptoms of vaginal atrophy the best, but also 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. Over the counter vaginal gel, like repHresh, can also be used to help restore normal vaginal pH. Douching should be avoided at all costs (CDC/NIH).
- To learn more about hormone therapy options, you should make an appointment with your primary care physician, oncologist, or OBGYN. They will be better equipped to discuss the hormone options available to you. Some of these options may include:
- Vaginal low-dose estrogen therapy
- Systemic hormone therapy (or hormone replacement therapy)
- Ospemifene (or Osphena) (CDC/NIH)
- To learn more about hormone therapy options, you should make an appointment with your primary care physician, oncologist, or OBGYN. They will be better equipped to discuss the hormone options available to you. Some of these options may include:
There are many options, and new options being researched, to help ease the symptoms and development of vaginal atrophy. There is no need to avoid sexual acts or activity while dealing with atrophy, although you may need to adjust how certain acts occur, or where pleasure is found. Intimate and sexual acts stimulate the body and increase blood flow, which can help to produce natural fluids in the vaginal tissues when stimulated.
If you experience any side effects or new symptoms while on any treatment plan for atrophy, discuss this with your doctors to ensure you can remain comfortable through treatment.
If you believe your vaginal issues and pain may be due to vaginal atrophy, reach out to your doctor to schedule an appointment to begin planning and taking action to find relief.
Citations:
National Institutes of Health
Centers for Disease Control and Prevention
Health Line
Intimate Rose