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Vaginal atrophy

Vaginal atrophy, also called atrophic vaginitis, is thinning, drying and inflammation of the vaginal walls due to your body having less estrogen. Vaginal atrophy occurs most often after menopause, but it can also develop during breast-feeding or at any other time your body's estrogen production declines.

For many women, vaginal atrophy makes intercourse painful — and if intercourse hurts, your interest in sex will naturally decrease. In addition, healthy genital function is closely connected with healthy urinary system function.

Simple, effective treatments for vaginal atrophy are available. Reduced estrogen levels result in changes to your body, but it doesn't mean you have to live with the discomfort of vaginal atrophy.

Symptoms Causes Risk factors Complications Prevention

With moderate to severe vaginal atrophy, you may experience the following vaginal and urinary signs and symptoms:

  • Vaginal dryness
  • Vaginal burning
  • Vaginal discharge
  • Genital itching
  • Burning with urination
  • Urgency with urination
  • More urinary tract infections
  • Urinary incontinence
  • Light bleeding after intercourse
  • Discomfort with intercourse
  • Decreased vaginal lubrication during sexual activity
  • Shortening and tightening of the vaginal canal

When to see a doctor

By some estimates, nearly half of postmenopausal women experience vaginal atrophy, although few seek treatment. Many women resign themselves to the symptoms or are embarrassed to discuss them with their doctor.

Make an appointment to see your doctor if you experience painful intercourse that's not resolved by using a vaginal moisturizer (Replens, Vagisil Feminine Moisturizer, others) or water-based lubricant (glycerin-free versions of Astroglide, K-Y Intrigue, others) or if you have vaginal symptoms, such as unusual bleeding, discharge, burning or soreness.

Vaginal atrophy is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile.

A drop in estrogen levels and vaginal atrophy may occur:

  • After menopause
  • During the years leading up to menopause (perimenopause)
  • During breast-feeding
  • After surgical removal of both ovaries (surgical menopause)
  • After pelvic radiation therapy for cancer
  • After chemotherapy for cancer
  • As a side effect of breast cancer hormonal treatment

Vaginal atrophy due to menopause may begin to bother you during the years leading up to menopause, or it may not become a problem until several years into menopause. Although the condition is common, not all menopausal women develop vaginal atrophy. Regular sexual activity, with or without a partner, can help you maintain healthy vaginal tissues.

Certain factors may contribute to vaginal atrophy, such as:

  • Smoking. Cigarette smoking affects your blood circulation, resulting in the vagina and other tissues not getting enough oxygen. Smoking also reduces the effects of naturally occurring estrogens in your body. In addition, women who smoke typically experience an earlier menopause.
  • No vaginal births. Researchers have observed that women who have never given birth vaginally are more likely to develop vaginal atrophy than women who have had vaginal deliveries.
  • No sexual activity. Sexual activity, with or without a partner, increases blood flow and makes your tissues more elastic.

Vaginal atrophy increases your risk of vaginal infections and urinary problems.

  • Vaginal infections. Vaginal atrophy leads to a change in the acid balance of your vagina, making you more likely to get a vaginal infection (vaginitis).
  • Urinary problems. Atrophic vaginal changes are associated with changes in your urinary system (genitourinary atrophy), which can contribute to urinary problems. You might experience increased frequency or urgency of urination or burning with urination. Some women experience more urinary tract infections or incontinence.

Regular sexual activity, either with or without a partner, may help prevent vaginal atrophy. Sexual activity increases blood flow to your vagina, which helps keep vaginal tissues healthy.

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