This article explores vaginal atrophy, highlighting causes, symptoms, and current treatment options. It discusses hormonal influences, risk factors, diagnosis methods, and innovative therapies like topical estrogen, SERMs, and TSEC. Emphasizing ongoing research, the piece offers insights into managing symptoms and improving quality of life for women affected by GSM.

Vaginal Atrophy Explained: Causes, Symptoms, and Relief Options

"Cherish what you have while working toward new goals." – Helen Keller

Often occurring after menopause, vaginal atrophy results from age-related changes in the reproductive organs. Still, hormonal fluctuations from puberty onward can influence this condition. Known as genitourinary syndrome of menopause (GSM), it impacts both vaginal and urinary health. Conventional treatments have limitations, fueling ongoing research to find better solutions.

What is vaginal atrophy?

Thinning and reduced elasticity of vaginal tissues and muscles.

This causes dryness, discomfort, and pain during intercourse (dyspareunia).

Prevalence of GSM

Difficulty in accurate estimation due to underreporting, as many women hesitate to seek medical help.

Unawareness that symptoms are linked to hormonal shifts often delays diagnosis.

Signs and symptoms

Includes dryness, burning, itching, abnormal discharge, painful sex, and minor bleeding post-intercourse.

Urinary symptoms like frequent urination, burning, urgency, and incontinence are common companions.

Psychological effects such as feeling less attractive, insecurity, and depression may also appear.

Factors raising risk

Main cause: hormonal changes during menopause.

Smoking decreases blood flow and estrogen effectiveness.

Use of certain medications like contraceptives or drugs affecting breastfeeding.

History of cesarean or unusual vaginal deliveries increases susceptibility.

Sexual inactivity may reduce blood circulation to the vaginal area.

Autoimmune diseases like Sjögren’s syndrome and diabetes.

Diagnosis methods

Medical history review and pelvic exam to identify other issues like prolapse.

Assessment of urinary symptoms and exclusion of other causes.

Tests of vaginal pH and fluid analysis, sometimes using pH indicator papers.

Available treatment options

While a complete cure is challenging, many therapies help reduce symptoms.

Hormone replacement therapy is less common now due to potential risks.

Moisturizers and lubricants, especially natural oils, offer relief but may cause allergies.

Topical estrogen creams, rings, and tablets are effective; proper dosing prevents systemic effects.

Regular sexual activity promotes blood flow and symptom improvement.

New treatments include local androgen therapy, with ongoing studies on testosterone’s effects on vaginal tissue.

Research into SERM and TSEC

Studies on selective estrogen receptor modulators (SERMs) show potential for symptom relief and tissue protection.

Tissue-selective estrogen complexes (TSEC) combined with estrogen are being investigated to optimize menopause-related treatment. Further research is vital.