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Causes of Vaginal Atrophy

So what is vaginal atrophy or Genitourinary Syndrome of Menopause (GSM)? Vaginal atrophy may also be called vaginal dryness, vulvovaginal atrophy, or atrophic vaginitis. Atrophy occurs when the vaginal tissue and vulva become thin and inflamed due to low estrogen related to:

  • Menopause
  • Certain types of medications
  • Cancer treatment
  • Oophorectomy (ovary removal surgery)

Symptoms of Vaginal Atrophy

  • Painful intercourse
  • Vaginal dryness during sex
  • Vaginal itching
  • Vaginal burning
  • Recurrent vaginal infections
  • Decreased vaginal lubrication
  • Changes in vaginal discharge
  • Urinary incontinence
  • Recurrent urinary tract infections
  • Changes in the vaginal canal

Who is Affected by Vaginal Atrophy?

The average age of menopause in the US is 51 to 53, but you can experience symptoms of menopause, like vaginal atrophy, 10 years prior. Whether you are in your 40s, 50s, or 60s, these symptoms may impact you.

Common misconceptions include:

  • “This is just aging.”
  • “This is just the natural progression of things.”

Impact on Quality of Life:

  • Pain during intercourse
  • Pain during biking or other exercises
  • Discomfort in daily life to decreased vaginal moisture

Please don’t suffer needlessly when we have many options for treatment. This condition does not typically resolve on its own if left untreated. Successful treatment can help you:

  • Resume sexual activity
  • Exercise without discomfort
  • Feel more comfortable navigating daily life
  • Maintain overall vaginal health

Other Causes of Vaginal Atrophy

Medications like some hormonal birth control, antihistamines, etc, that can cause vaginal atrophy. This is reversible with treatment or cessation of the medication. You should talk to your healthcare provider before stopping medications, and discuss possible next steps or treatment. You should also speak to your doctor about other ancillary services that you could benefit from, especially if you are experiencing pelvic pain or other vaginal symptoms, including bacterial vaginosis.. If you have been struggling with pain related to vaginal atrophy, you could have also developed pelvic floor dysfunction, which can be treated by a pelvic floor physical therapist.

Treatment Options

How do we treat this painful and uncomfortable problem? Patients may choose prescription or over-the-counter options. They may require long term treatment or short term/episodic treatment. Your provider could recommend:

Prescription options

  • Estradiol vaginal cream
  • vaginal tablet or ring.
  • Nonhormonal prescription cream based on your preference and risk factors.

Working with your healthcare provider can lead you to making an informed decision that works best for you at this time, and can be modified throughout the lifespan.

Conclusion

My hope is that you learned something from this blog and it can benefit you (or someone you know) moving forward. While aging and vaginal concerns are not typical dinner party conversation, it is so important we bring light to this topic and normalize its symptoms and treatments. If we can treat these issues early and effectively, we can improve patient’s lives, their comfort level, and their confidence to navigate their gynecologic and sexual health. Please feel empowered to take the next step in bringing this up to your healthcare provider, because we would be honored to help you on the road to feeling better. And don’t forget to share this info with a friend! You’re not alone, and sharing this information could improve your life, and the lives of the people you love.

 

 

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Adrienn Myers-Woods, WHNP, APN is a board certified Women's Health Nurse Practitioner.

She completed her undergraduate degree in Nursing at Truman State University and was commissioned into the Army Reserves through the ROTC program. Adrienn grew up in a very rural area with only one clinic for the entire county. She had decided healthcare was her dream, and after seeing the lack of focus on women's health in the military and civilian life, she knew where her focus must be. She received her Master of Science in Nursing with a specialty in Women's Health from Vanderbilt University. 

Adrienn has 7 years of experience as a nurse practitioner in various fields ranging from fertility/IVF, family planning, and routine gynecologic care. Her goal is to provide high quality care, but also high quality education to each and every patient. 

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