Vaginal Atrophy: Symptoms, Management, Treatment, & Prevention, Part Two.

In part two of our “Vaginal Atrophy” article series, we touch more on the symptoms, management, treatment, and ways to prevent vaginal atrophy. If you missed Part One, you could read it here.

Causes of Vaginal Atrophy

In certain moments in life, estrogen begins to lessen, and the body begins making less. Without estrogen, many changes occur within the body, including menopause. With less estrogen in the body, the lining of the vagina becomes thinner and hardens, which also shortens and narrows the canal. This also creates very dry, painful tissues which is typically when people begin to reach out for help.

Diagnosing Vaginal Atrophy

Your medical care provider will diagnose your vaginal atrophy based on the symptoms you report and with a pelvic exam to check the overall appearance of the vagina. Some of the typical signs of atrophy are:

  • Dryness, redness, and swelling
  • Loss of skin pliability, or stretch
  • A shortened, narrowed vagina
  • Discoloration of the vagina, often a whiteish hue
  • Sparsity of pubic hair
  • A bulge in the back wall area of the vagina
  • Vulvar skin conditions (dermatoses), lesions or patches of redness (erythema)
  • A sagging bladder (this means the bladder is falling or has fallen into the vagina)
  • Urethral lesions
  • Minor lacerations near the vaginal opening

Testing for Vaginal Atrophy

More often than not, the physical examination is enough to properly diagnose atrophy. In the cases where laboratory tests are required, the tests ordered may be:

  • Urine sample
  • Pap smear
  • Ultrasound
  • Serum hormone testing
  • Vaginal pH
  • Microscopy

Your medical care provider may also ask you questions similar to 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?

Many 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.

How to Manage & Treat Vaginal Atrophy

After your diagnosis, you and your healthcare provider can decide on the best treatment plan for your situation. Many people opt to begin with a more holistic approach with natural lubrications and moisturizers, compiled with dilator therapy. Others opt for estrogen therapy or surgical intervention. Some treatments treat the symptoms only, whereas other treatments address the loss of estrogen, which thusly helps to treat the symptoms.

  • Lubrications 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 Flourish, and silicone-hybrid aloe-based lubrications like 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) for many. Reclaiming Intimacy offer a daily moisturize that uses seaweed and natural properties to help to restore natural moisture. Lustrous is designed for daily use.
  • 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. Reclaiming Intimacy offers high quality dilator sets, Rejuvenate and Revitalize, to get your started on your dilator therapy journey.
  • 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.
    • To learn more about hormone therapy options, you should make an appointment with your primary care physician, 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)

There are many options available to help combat the symptoms of vaginal atrophy. Sexual activity should not be avoided while dealing with atrophy, although one may need to change how they find pleasure. Sex and intimacy stimulate blood flow to the vagina which helps to produce natural fluids and moisture, which will help to lessen the atrophy symptoms.

If you experience any side effects or new symptoms while on any treatment plan for atrophy, discuss this with your healthcare provider to ensure you can remain comfortable through treatment.

Prevention of Vaginal Atrophy

Female bodies naturally lose estrogen production with age and serious medical conditions, which cannot be prevented. While prevention is not possible, one can work to lessen symptoms and keep the atrophy from worsening any further. One can begin by avoiding tight-fitting clothing, panty liners, perineal pads or any of the following things that you might find irritating your vagina:

  • Powders
  • Perfumes
  • Douches
  • Deodorants
  • Spermicides
  • Lubricants
  • Tampons
  • Condoms (made from certain materials)

If you find yourself struggling with vaginal atrophy, do not hesitate to reach out to your medical care provider for guidance and treatment.

Resources Used:

Reclaiming Intimacy

Vaginal Atrophy Series: Part One, Two, Three

Vaginal Atrophy: The Basics, Part One.

Vaginal Atrophy: Symptoms, Management, Treatment, & Prevention, Part Two.

Vaginal Atrophy: Living with Vaginal Atrophy, Part Three.

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