When your body enters perimenopause, it begins producing less estrogen. A decrease in estrogen causes the lining of your vagina to become dryer, thinner and more easily irritated. The resulting condition, which can occur prior to or after menopause, is called vaginal atrophy. It can lead to painful intercourse and urinary tract issues, negatively impacting your quality of life.
Vaginal atrophy, and the symptoms that accompany it, are now more commonly known as Genitourinary syndrome of menopause (GSM).
Care for Vaginal Atrophy (GSM)
A significant number of women experience vaginal atrophy or the accompanying symptoms – up to 50% of those who enter menopause – but many fail to seek treatment for it. It is believed they are hindered by shame, embarrassment or lack of education about treatment options. It’s important to note that many different treatment options are available, and over time, you can get relief and improve quality of life. A trusted provider can help you effectively deal with this condition.
Common Symptoms and Signs of Vaginal Atrophy
You may first notice reduced lubrication during sex. Other GSM symptoms can include:
- Dyspareunia (pain during sex)
- Burning or itching in your vagina or vulva (external genitalia)
- Yellow or other unusual discharge from your vagina
- Frequent or painful urination
- Blood in your urine
- Recurrent urinary tract infections (UTI)
- Bleeding during sex
- Shortening of the vagina canal
- Urinary incontinence or urgency
Vaginal Atrophy Causes and Risk Factors
GSM most commonly occurs after menopause due to reduced estrogen production. Estrogen loss due to breastfeeding, cancer treatment, immune disorders, certain medications or removal of one or both ovaries can also cause GSM.
Smoking, lack of sexual activity and having never delivered a child vaginally may contribute to or worsen GSM, due to decreased blood flow and, in the case of smoking, a reduction in the effects of your body’s naturally occurring estrogens. Having GSM makes you more likely to experience urinary tract problems and vaginal infections.
How Is Vaginal Atrophy Diagnosed?
A women’s health provider can diagnose GSM through a pelvic exam and consultation about the symptoms you’re experiencing. They will ask about your medical history and look for changes in the size of your labia or vagina, vulvar lesions or skin irritation, and loss of elasticity.
Your provider may also perform or recommend tests to rule out infection or other causes of your symptoms, including Pap smear, vaginal pH test or ultrasound.
Treatment Options for Vaginal Atrophy
Hormonal Treatment Options
Hormone therapies for GSM include the use of estrogens, dehydroepiandrosterone (DHEA) and selective estrogen receptor modulators.
Topical estrogens can be delivered through a cream, pill, suppository or vaginal ring. All hormonal therapies work by increasing blood flow, elasticity, collagen, lubrication and improving vaginal pH while minimally increasing estrogen levels in your bloodstream. Your provider can help you determine which option would be the most effective for treating your symptoms.
Non-hormonal Treatment Options
Over-the-counter vaginal lubricants can provide short-term relief during sexual activity by reducing pain and friction. Moisturizers can alleviate symptoms for up to a few days per application.
Prescription medication solutions that do not contain estrogen, including pain relievers such as topical lidocaine, are available to relieve vaginal dryness and increase comfort during sex.
Physical therapy using dilators to slowly widen the vagina over time can help reduce pain due to vaginal atrophy. This may be combined with pelvic floor physical therapy in more severe cases.
Additionally, avoiding perfumes, detergents, douches and other irritants can help reduce the discomfort that comes with GSM.
How Advantia Health Can Help
At Advantia Health, we recognize that perimenopause and menopause can bring with them an array of new issues and conditions that could be needlessly impacting your quality of life, including GSM and its related symptoms. Because GSM will worsen without treatment, it is important that you seek attention when you first experience symptoms.
Our compassionate providers will work with you to identify how you’re being impacted and provide a comprehensive, personalized care plan, while making you feel comfortable with sharing your concerns. Our specially trained and experienced providers are here to guide and support you at every stage of your journey.
Book An Appointment!
If you’re ready to take the first step towards a more satisfying perimenopause or menopause experience, we encourage you to schedule an appointment with one of our experienced team members at Advantia Health today. Together, we can embark on a journey to address GSM and your overall well-being.
