Vulvovaginal atrophy affects most women during menopause, as it is a process associated with the decline in oestrogen production that this stage involves. The main symptoms are: vaginal dryness, reduced lubrication, itching, irritation, burning sensation, thinning of vaginal walls, loss of vagina elasticity, changes in the balance of flora and pH, and shortening and tightening of the vaginal cavity.
This problem can also occur after childbirth and breastfeeding (due to hormonal decline), as well as in patients who have received chemotherapy or radiotherapy treatment to treat cancer, following surgery to remove the ovaries or due to premature ovarian failure.
There are various degrees, and it does not affect all women equally, but it is important to act in the face of the first symptoms, as some of these disorders may cause problems that decrease quality of life, such as urinary incontinence, vaginal laxity or painful sexual intercourse, as well as contributing to the predisposition to urinary infections. It is also an evolutionary process that worsens over time.
To refer to this process and the symptoms that accompany it, doctors use the term “genitourinary syndrome of menopause (GSM)”.
Treatment of vulvovaginal atrophy
Vulvovaginal atrophy can be treated both functionally and physically. There are multiple options: from moisturising creams and gels to locally applied drugs that contain very low doses of hormones. In the event that they are not effective or there are contraindications, regenerative gynaecology treatments may be chosen.
All treatments must always be prescribed in a personalised manner and under medical indication.
FAQs
Can you have vaginal atrophy and not notice any symptoms?
Yes, there is a percentage of women in menopause who never experience symptoms, or these changes are so light that they do not affect quality of life.
How is the vaginal atrophy problem detected?
The most important thing is that the patient who has symptoms or begins to have them communicates it to their gynaecologist. In gynaecological annual check-ups, atrophy can be easily observed during the examination and also when doing smear tests. Symptoms may vary from one woman to another, although the most common are skin and mucous membranes thinning, tissue paleness, pain when examining the vulvovaginal area, lack of hydration and a feeling of dryness or pain when there is contact and during sexual penetration.
Can having small urine leaks or losses be a symptom of vulvovaginal atrophy?
If you are at the menopause stage, it can be a consequence of atrophy.
Should this type of treatment be applied for life?
It depends on symptoms, but most of the time it will require constant monitoring, because vaginal atrophy is not a reversible problem. The decrease in oestrogen cannot be recovered. However, there are different vulvovaginal health measures that are safe and effective. Each case must be assessed individually to establish the dosing and maintenance of any therapeutic indication.
From the point of view of hygiene and personal care, what is recommended?
In general, it is advisable to wear cotton underwear and avoid very tight garments, not to sit continuously for a long time or spend many hours on a bicycle or motorbike. As for hygiene, it is recommended to use mild soaps with a suitable pH and avoid prolonged contact of the vulvovaginal area with wet clothes or wet surfaces, which can favour the onset of vaginal or urinary infections.
