by Chrissie Seals, WHNP, Salud Spa
Many women will experience changes throughout their lifetime that affect their vaginal tissues.
Studies show that 95% of women will experience significant atrophic vaginitis (dryness of the vagina), and only 5% realize there is effective treatment available.
The epithelial cells that line the vagina are hormonally signaled by estrogen to increase healthy secretions and lubrication. Symptoms that occur due to changes in hormones can cause vaginal dryness.
Declining fertility and lower systemic estrogen levels may occur at the age of 35 or 40. Other women will experience moderate to severe vaginal dryness, pain with intercourse, burning and urinary symptoms in the early 50s, which also is a common age of onset for menopause.
Lack of estrogen in vaginal tissues thins the vaginal tissues and increases the incidence of urinary symptoms — urinary infection and incontinence. Less sexual activity can also lead to more fragile tissue and loss of elasticity.
Treatment of vaginal symptoms requires careful evaluation to rule out other issues such as yeast, bacterial vaginosis or sexually transmitted infection. Vaginal cancer also can cause some of the same symptoms as atrophic vaginitis.
Vaginal estrogen can be effectively used to promote vaginal wellness. The decision to use vaginal estrogen for these common symptoms should be individualized. Many clinicians do not believe that vaginal estrogen leads to a systemic level of hormone in the blood stream and should not increase the risk for breast cancer in high-risk patients.
Some patients may choose an estrogen-free option to completely minimize the risk, and there are medications available.
Lubricants or vaginal moisturizers are often not enough to help most women. Over the counter treatments such as vaginal wipes, sprays and cleansers may cause more harm than benefit.