The most common symptoms of vaginal atrophy are dryness, irritation, and pain during intercourse. Although menopause is the most common cause, vaginal atrophy can result from anything that lowers estrogen production. That includes chemotherapy, radiation, removal of the ovaries during hysterectomy, and use of anti-estrogenic therapies such as aromatase inhibitors, tamoxifen Nolvadex , and drugs like leuprolide Lupron and nafarelin Synarel , which are used to treat fibroids and endometriosis. Unlike hot flashes, which usually subside with time, vaginal atrophy is likely to persist and become worse without treatment. Loss of estrogen decreases blood flow to the vagina, causing vaginal tissue to become thinner, drier, and less elastic.
Chronic dryness and irritation can be a daily misery, and some women find that sexual intercourse is so painful that Vaginal apathy must How to fuck anybody it altogether — a distressing development for both the woman and her partner. This article examines some helpful natural remedies, lifestyle changes, and medical treatments that can reduce symptoms and enhance quality of life for women with vaginal atrophy. They can make sexual intercourse more comfortable, but they're Vaginal apathy a substitute for vaginal lubricants, which are more slippery. New York, N. If none of these approaches helps, you may need low-dose estrogen in the form of a cream, tablet, or ring inserted into the vagina. Effective natural and medical management of vaginal atrophy means that a woman can resume with a good Vaginal apathy of life. Keep in mind that it's not cosmetic surgery. Reversal therapies.
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This article examines some helpful natural remedies, lifestyle changes, and medical treatments that can reduce symptoms and enhance quality of life for women with vaginal atrophy.
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- Susan Kaye.
- Many women experience vaginal atrophy during and after menopause.
- For women who suffer from atrophic vaginitis, or vaginal atrophy, sex is incredibly painful, but hopefully, help is on the way.
- One of the most irritating pun unintended side effects of menopause and aging for many women is vaginal dryness.
- Atrophic vaginitis is inflammation of the vagina as a result of tissue thinning due to not enough estrogen.
Vaginal atrophy atrophic vaginitis is thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen. Vaginal atrophy occurs most often after menopause. For many women, vaginal atrophy not only makes intercourse painful but also leads to distressing urinary symptoms.
Because the condition causes both vaginal and urinary symptoms, doctors use the term "genitourinary syndrome of menopause GSM " to describe vaginal atrophy and its accompanying symptoms.
Simple, effective treatments for GSM are available. Reduced estrogen levels result in changes to your body, but it doesn't mean you have to live with the discomfort of GSM. Many postmenopausal women experience GSM. But few seek treatment. Women may be embarrassed to discuss their symptoms with their doctor and may resign themselves to living with these symptoms.
Make an appointment with your doctor if you have any unexplained vaginal spotting or bleeding, unusual discharge, burning, or soreness. Also make an appointment to see your doctor if you experience painful intercourse that's not resolved by using a vaginal moisturizer K-Y Liquibeads, Replens, Sliquid, others or water-based lubricant Astroglide, K-Y Jelly, Sliquid, others.
Genitourinary syndrome of menopause is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile. GSM signs and symptoms may begin to bother you during the years leading up to menopause, or they may not become a problem until several years into menopause.
Although the condition is common, not all menopausal women experience GSM. Regular sexual activity, with or without a partner, can help you maintain healthy vaginal tissues. Certain factors may contribute to GSM , such as:. Regular sexual activity, either with or without a partner, may help prevent genitourinary syndrome of menopause. Sexual activity increases blood flow to your vagina, which helps keep vaginal tissues healthy. Mayo Clinic does not endorse companies or products.
Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Vaginal atrophy atrophic vaginitis is thinning, drying and inflammation of the vaginal walls that may occur when your body has less estrogen. Request an Appointment at Mayo Clinic.
Share on: Facebook Twitter. Show references AskMayoExpert. Genitourinary syndrome of menopause adult. Rochester, Minn. Shifren JL. Genitourinary syndrome of menopause. Clinical Obstetrics and Gynecology. DeCherney AH, et al. Menopause and post-menopause. New York, N. Accessed March 1, Thomas HN, et al. Female sexual function at midlife and beyond. Obstetrics and Gynecology Clinics of North America. Bachman G, et al.
Clinical manifestations and diagnosis of genitourinary syndrome of menopause vulvovaginal atrophy. Accessed March 3, Alligood-Percoco NR, et al. Risk factors for dyspareunia after first childbirth. Obstetrics and Gynecology. Lethaby A, et al.
Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database of Systematic Reviews. Biehl C, et al. A systematic review of the efficacy and safety of vaginal estrogen products for the treatment of genitourinary syndrome of menopause.
Di Donato V, et al. Ospemifene for the treatment of vulvar and vaginal atrophy: A meta-analysis of randomized trials. Part I: Evaluation of efficacy. Part II: Evaluation of tolerability and safety. Menopausal symptoms in depth. National Center for Complementary and Integrative Health. Yaralizadeh M, et al.
Effect of Foeniculum vulgare fennel vaginal cream on vaginal atrophy in postmenopausal women: A double-blind randomized placebo-controlled trial. Imvexxy prescribing information. Boca Raton, Fla. Accessed March 18, Mayo Clinic Marketplace Check out these best-sellers and special offers on books and newsletters from Mayo Clinic.
With women living much longer than they did in previous eras, vaginal atrophy has become a major concern in the women's health community. Vaginal atrophy is a series of natural changes which take place in the vagina as women age and their estrogen levels decrease. Questions for your doctor. Treatment is generally with estrogen cream applied to the vagina. Side effects of estrogen replacement. I am starting treatment with estrogen cream for three months and then surgery to fix my fused labia minora, which fused together and are partially covering my vaginal opening.
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Atrophic vaginitis - Wikipedia
The most common symptoms of vaginal atrophy are dryness, irritation, and pain during intercourse. Although menopause is the most common cause, vaginal atrophy can result from anything that lowers estrogen production.
That includes chemotherapy, radiation, removal of the ovaries during hysterectomy, and use of anti-estrogenic therapies such as aromatase inhibitors, tamoxifen Nolvadex , and drugs like leuprolide Lupron and nafarelin Synarel , which are used to treat fibroids and endometriosis.
Unlike hot flashes, which usually subside with time, vaginal atrophy is likely to persist and become worse without treatment. Loss of estrogen decreases blood flow to the vagina, causing vaginal tissue to become thinner, drier, and less elastic. The top layer of the epithelium the cells lining the vagina may be entirely lost, leaving the layer below vulnerable to inflammation, infection, or trauma when it's exposed to any pressure, including sexual activity, a Pap smear, or the insertion of a speculum.
The vaginal environment becomes less acidic, reducing the number of beneficial flora lactobacilli and encouraging the growth of organisms that cause vaginal and urinary tract infections. As vaginal secretions decline, sexual intercourse can become more painful and may be followed by bleeding or spotting.
Other common symptoms of vaginal atrophy are itching, burning, and discharge. The best treatment for vaginal atrophy — no surprise — is estrogen. It's generally considered safe when applied to the vagina at a low dose. In the early stages of vaginal atrophy, you may have no symptoms or only mild ones, such as a slight decrease in vaginal lubrication during sexual activity.
But prolonged lack of estrogen can adversely affect a woman's quality of life. Chronic dryness and irritation can be a daily misery, and some women find that sexual intercourse is so painful that they must avoid it altogether — a distressing development for both the woman and her partner. Estrogen loss isn't the only cause of bothersome vaginal symptoms in postmenopausal women, so your clinician will want to review your medical and sexual history and ask about the medications you take some, like certain antihistamines, can cause vaginal dryness.
A pelvic examination is also important, although women with severe symptoms may be understandably worried at the prospect of having one. If you've had pain or bleeding, let your clinician know, and ask her or him to use the narrowest speculum. Signs of vaginal atrophy include a pale, smooth, or shiny vaginal epithelium; narrowing and shortening of the vagina; loss of vaginal elasticity; dryness at the entrance to the vagina; loss of labial plumpness, which can give the outer labia labia majora a pendulous appearance; and sparse pubic hair.
Laboratory tests are rarely used except to rule out other problems, such as lichen sclerosis or an infection, but if there's any question, your clinician may check your vaginal pH acidity level or examine a sample of cells taken from the upper third of the vagina under the microscope. Vaginal moisturizers are inserted into the vagina with an applicator once every few days to relieve vaginal dryness.
They can make sexual intercourse more comfortable, but they're not a substitute for vaginal lubricants, which are more slippery.
Vaginal moisturizers can be messy the vagina absorbs what it needs and sheds the rest , so it may be helpful to wear a sanitary pad or panty liner while using one. Vaginal lubricants are applied to the vaginal opening or to the penis at the time of sexual activity, to ease vaginal discomfort.
They can be either water-based or silicone-based. Eros and ID Millennium are silicone-based. Silicone-based products last longer and can be used in smaller amounts than water-based ones. This estradiol-infused silicone ring is inserted in the vagina once every three months and releases 7. Estring does not interfere with intercourse. An estradiol tablet is inserted into the vagina using an applicator or finger every day for two weeks and twice a week thereafter.
Vaginal estrogen creams are sold with an applicator designed to deliver more estrogen than is recommended for treating vaginal atrophy. Clinicians sometimes recommend starting with one-eighth of an applicator, inserted into the vagina daily for two to three weeks and twice a week thereafter.
If symptoms are severe, your clinician may recommend a larger amount. Treatments range from over-the-counter moisturizers to prescription-only hormone therapy see "Products that help treat vaginal atrophy". You can often manage mild symptoms with nonhormonal moisturizers and, during sexual intercourse, vaginal lubricants.
Sexual activity itself may improve the symptoms see "Sexual activity helps maintain vaginal tissues". If none of these approaches helps, you may need low-dose estrogen in the form of a cream, tablet, or ring inserted into the vagina. Here's how the various options work:. Sexual activity helps maintain a healthy vaginal epithelium the cells lining the vaginal walls , increases vaginal elasticity, and improves lubrication in response to sexual arousal. It also helps keep the vagina more acidic, providing some protection against infection.
These benefits have nothing to do with estrogen levels; they result from increased blood flow to the vagina and possibly higher levels of androgens and other hormones. Women who are sexually active with a partner or through masturbation report fewer symptoms of atrophic vaginitis and have less evidence of tissue atrophy, compared with women who aren't sexually active. In one study, postmenopausal women who had sexual intercourse more than three times a week had less vaginal atrophy than those who had intercourse less than 10 times per year.
Low-dose vaginal estrogen appears to be safe. As part of the Nurses' Health Study, the long term use of vaginal estrogen did not increase the risk of cardiovascular disease or cancer. Vaginal estrogen products can cause a small increase in estrogen blood levels. Estrogen exposure may be a concern for women who have vaginal atrophy resulting from chemotherapy or anti-estrogenic therapy for estrogen receptor—positive breast cancer.
Many oncologists approve the use of a low-dose vaginal estrogen for these patients because it can greatly improve their quality of life. Estring and Vagifem are generally preferred, because they result in less systemic estrogen absorption, compared with vaginal creams. Available evidence suggests that women using low-dose vaginal estrogen don't need to be monitored for endometrial changes and don't need to take a progestin to reduce the risk of endometrial cancer , although some experts recommend it.
Disclaimer: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review on all articles. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician. Harvard Women's Health Watch. Vaginal dryness is one of the most irritating symptoms of menopause. Here are some ways to relieve it.
Updated: June 19, Published: March, Women's Health Women's Sexual Health. E-mail Address. First Name Optional. Sexual activity helps maintain vaginal tissues Sexual activity helps maintain a healthy vaginal epithelium the cells lining the vaginal walls , increases vaginal elasticity, and improves lubrication in response to sexual arousal.