What is Vaginal Atrophy?
Vaginal dryness can affect any woman, however after the menopause it is very common.
During menopause, oestrogen production slows and then stops. When that happens, a number of changes, many of them unwelcome, happen in a woman’s body. Periods become irregular and then stop. You may have hot flushes, mood swings, a deeper voice, and an increase in facial hair.
Vaginal dryness is another common symptom of menopause and close to one out of every three women experiences it while going through “the change”. And it becomes even more common after menopause. Vaginal dryness also can occur at any age from a number of different causes. It may seem like a minor irritation back the lack of vaginal moisture can have a huge impact on your sex life.
What causes vaginal dryness?
Normally, the walls of the vagina stay lubricated with a thin layer of clear fluid. The hormone oestrogen helps maintain that fluid and keeps the lining of the vagina healthy, thick, and elastic. During menopause, the drop in oestrogen levels reduces the amount of moisture available. It also makes the vagina thinner and less elastic. This called vaginal atrophy.
In addition to menopause, oestrogen levels can drop from:
Childbirth and breastfeeding
Radiation or chemotherapy treatment for cancer
Surgical removal of the ovaries
Anti-oestrogen medications used to treat uterine fibroids or endometriosis
Other causes of vaginal dryness include:
Sjögren’s syndrome (an automimmune disorder that attacks cells in the body that produce moisture)
Allergy and cold medication and certain antidepressants
No matter what the cause, vaginal dryness can be extremely uncomfortable. It can lead to itching, burning, and painful intercourse.
What are the symptoms of vaginal dryness?
Loss of lubrication and pain during sex (after the menopause problems with lubrication and painful sex). Thinning of the skin around the vagina makes it more open to damage. This can damage can often occur during sex, especially of lubrication is poor. Even gentle friction can cause pain and discomfort. Painful intercourse can then have a knock on effect contributing to a loss of sexual desire. The relief of symptoms often leads to an increased sexual desire and arousal.
Paining during other times: Vaginal dryness does not only cuase pain during sex but it can make it uncomfortable to sit, stand, exercise or urinate. Vaginal dryness can affect everyday life, whether women are sexually active or not. This can have a detrimental effect on quality of life.
Change in the appearance of the vagina and vulva – it is common for the vagina to look different; the lips will be much thinner.
Changes to the vaginal discharge – many women also find that their vaginal discharge changes, becoming more watery, discoloured and slightly smelly and they may experience irritation and a burning feeling. These symptoms can be worrying but they are simply due to the hormonal changes and not an indication of something more serious.
Emotional impact – changes to the body can be difficult to accept and pain and discomfort caused by the condition can lead to a loss in self-confidence and sexual confidence.
How is vaginal dryness diagnosed?
Any buring, itching, or discomfort in the vaginal area warrants a call to your doctor or gynaecologist. The doctor will take a health history and find out how long you have been experiencing symptoms and whether anything, such as douching or taking medication, seems to worsen symptoms.
Your doctor will than carry out a pelvic exam, checking your vagina any thinning or redness. The pelvic exam will help rule out other possible causes for your discomfort, including urinary tract infection. The doctor may also do a Pap test to remove and test cells for your vaginal wall or cervix
How do I discuss vaginal dryness with my doctor?
Discussing vaginal dryness with a healthcare professional can be daunting however it is often well worth it as they will be able to help. Here are a few tips to make the discussion as easy as possible:
Make a list of what you want to discuss
Discuss the most important or more difficult questions first
Write down what the doctor tells you
If there is anything that you don’t understand, ask for clarification
If you feel embarrassed take along some information with you. It can be difficult to discuss embarrassing problems face to face, but if you find information on the internet about your symptoms you can use this to help explain and avoid having to make eye contact with your GP whilst discussing the problem.
If you still feel unable to discuss the subject, write it all down and hand it to the doctor.
Don’t wait to be asked, give the doctor any information that you may feel is relevant including a history of the condition, symptoms, the impact they are having on you, any lifestyle factors that may have contributed and any medication you are taking.
Many women find that their smears become more difficult, if this is the case, speak to the nurse about your symptoms and ask for some further information and advice about vaginal dryness.
Can vaginal dryness affect your sex life?
Yes. Most women will experience some sort of vaginal dryness while having sex at one time or another. While this may occur in any woman at any time, it is a more common problem for women who suffer from chronic vaginal dryness, for example after the menopause.