December 27th, 2016
Vaginal atrophy or atrophic vaginitis is a condition in which vaginal walls become dry, thin and inflamed. It happens in response to persistently low levels of estrogen, usually after menopause. Vaginal atrophy not only leads to painful sex and other vaginal symptoms but also induces a wide variety of disturbing urinary symptoms, due to which experts have agreed to a more appropriate term for vaginal atrophy i.e. “genitourinary syndrome of menopause (GSM).” It has been estimated that approximately 50% women experience GSM after menopause but not all the women go for treatment because of embracement in discussing their symptoms.
Following symptoms are usually experienced in moderate to severe GSM:
As discussed earlier, genitourinary syndrome of menopause (GSM) happens due to significant drop in the estrogen levels which reduces elasticity and lubrication of vagina and makes it more vulnerable to inflammation. In some women, the symptoms begin at a much younger age (long before the actual menopause), whereas some women will not suffer major change in the vaginal lubrication even after menopause.
Following are the factors that increases your risk of developing GSM:
Poorly managed GSM is associated with following complications:
It involves physical examination of vagina, cervix, and external genitals. Doctor will also look for bulging in vaginal walls, an indication of pelvic organ prolapses.
It is done to detect the acid balance of vagina either by inserting a paper indicator strip or taking sample of vaginal fluids.
In case any urinary symptoms are experienced, a urine sample is taken for evaluation.
Initially your doctor may suggest OTC products such as vaginal moisturizers (Vagisil Feminine Moisturizer, Replens) or water based lubricants (glycerin free K-Y Touch, Astroglide). If using condoms, avoid use of petroleum based products as it can break down the latex condoms.
When OTC products do not work, doctor may recommend topical estrogens, including:
A flexible ring placed on upper part of vagina which releases uniform dose of estrogen and is replaced after every 3 months.
It is directly applied inside vagina via applicator.
A tablet is inserted inside vagina via disposable applicator.
It includes estrogen gels, patches, pills, and high dose rings. If uterus is not removed, progestin is given along with estrogen. Usually oral progesterone is preferred but combination of estrogen-progestin patches may also be given.
Those with breast cancer will have different treatment approach.
Ask doctor before using herbal supplements as it is not approved by FDA and may lead to severe interactions with your medications. Frequent sexual activities will keep vagina healthy.
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