The fact that our bodies are constantly changing is probably something many of us are all too aware of, but what about the changes that take place in our vagina? This area of our body is also always in flux, and that's especially true during menopause, when things can start to feel pretty different down there.
Menopause causes your body's levels of the hormone estrogen to decrease, and that can affect your vagina and urinary tract. Over time, your vaginal lining can get thinner, dryer, and less elastic — and it's more common than you might think.
This condition, called vaginal atrophy, impacts 45 percent of women, according to a study published in the Journal of Menopausal Medicine.
Never heard of vaginal atrophy? Neither had we. So to find out more, we spoke to Dr Shree Datta, a consultant gynaecologist and ambassador for Intimina, about what symptoms to look out for, what to do if you have any and whether the condition can impact your fertility.
What is vaginal atrophy?
Vaginal atrophy, also known as atrophic vaginitis, occurs when the vaginal walls become thin, dry and inflamed. This may happen when your body has less oestrogen, for example at the point of menopause. This can lead to thinner, less elastic vaginal skin, which can result in sex becoming uncomfortable over time as well as urinary symptoms. There may also be a change in pH balance, which could affect your infection risk
What are the symptoms of vaginal atrophy?
Vaginal atrophy can result in a variety of symptoms which may develop gradually over time. These include vaginal burning, dryness, and a change in your vaginal discharge. You may notice that the skin around the vaginal opening becomes irritated, sore or itchy. Sex may become uncomfortable and you may notice some bleeding. Urinary symptoms include burning, going to the toilet frequently, needing to go urgently, and incontinence.
What should you do if you think you have vaginal atrophy?
It's important to consult your GP or Gynaecologist early so that we can prevent your symptoms from getting worse. In the first instance, we will assess your medical status and examine you to exclude other causes such as infection or skin disorders such as lichen sclerosis.
How do you treat vaginal atrophy?
We have several different treatments for vaginal atrophy. These include vaginal lubricants and moisturisers, oestrogen based creams, therapy, the use of selective estrogen receptor modulators, vaginal dehydroepiandrosterone as well as non-drug therapies which include dilator therapy. Timely diagnosis and treatment will prevent your symptoms from deteriorating.
How long does vaginal atrophy last for?
Unlike many other menopausal symptoms, vaginal atrophy generally does not improve unless treated. It can become a chronic condition as it results in physical skin changes and can affect your quality of life.
Is vaginal atrophy contagious?
Vaginal atrophy is not contagious, as it is not an infection in itself, rather a skin disorder restricted to the vagina.
Are some people more prone to vaginal atrophy?
Yes, you are more at risk of vaginal atrophy if you smoke, you have not delivered a baby vaginally or if you are not sexually active. Age-wise, approaching and going through the menopause increases your risk of vaginal atrophy, as does the period when you are breastfeeding.
Can vaginal atrophy affect fertility?
There is no clear evidence to suggest vaginal atrophy alone can affect fertility, however, it may signify that you are entering the menopause, which is associated with a decline in fertility. Vaginal atrophy can leave you more prone to vaginal infections or urinary problems.
What underwear would you recommend wearing if you have vaginal atrophy?
Whilst underwear may not cause vaginal atrophy, synthetic or tight underwear can aggravate the delicate skin around the opening to your vagina. The opening may also become thin and less elastic, and therefore prone to irritation and discomfort. So we would recommend you wear cotton loose underwear and avoid tight clothing as well as scented soaps or internal douching.
Should you avoid sex while you have vaginal atrophy?
You do not need to avoid sex if you have vaginal atrophy unless it is painful. If this is the case, it's worth getting assessed and treated before having sex to prevent vaginal atrophy from getting worse.
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