Atrophic / atrophic vaginitis (vaginal atrophy) is a common ailment in postmenopausal women and significantly reduces their quality of life, especially sexual life. Vaginal atrophy can also occur in younger women - most often those with hormonal problems. What are the causes and symptoms of atrophic vaginosis? What is the treatment of this condition?

Atrophic / atrophic vaginitis (vaginal atrophy, senile vaginitis)indicates a gradual decrease in the thickness of the vaginal epithelium, eventually leading to its disappearance.Vaginal atrophyis usually seen in postmenopausal women, but can also be diagnosed in younger women with hormonal imbalances. It is estimated that 1/3 of women in the perimenopausal period and 1/2 in the postmenopausal period have the so-called vaginal symptoms caused by vaginal atrophy.

Atrophic / atrophic vaginitis (vaginal atrophy) - causes

The main cause of vaginal atrophy ishypoestrogenism , orestrogen deficiency . These hormones, in the right concentration, help maintain a proper blood supply to the vaginal tissues, maintain the elasticity of the vaginal walls and stimulate the production of natural moisturizing substances.

In addition, estrogens help protect the vagina from bacterial infections. In the case of their deficiency, the number of cells that make up the vaginal mucosa decreases, as well as the moisturization of its walls (as a result of a reduction in the quantity and quality of vaginal discharge). As a consequence, the epithelium becomes thinner and the vagina shortens and narrows. In addition, harmful bacteria can multiply in the vagina.

Most often, estrogen levels fall after the menopause (between the ages of 50 and 70, when the ovaries stop producing these hormones).

Vaginal atrophycan also result from decreased or inhibited estrogen secretion after ovariectomy, damage to the ovaries through radiation therapy and chemotherapy, or environmental poisons such as smoking. Vaginal atrophy can also be a side effect of anti-estrogen drugs from the SERM group (to treat osteoporosis) or the SSRI group (to treat depression).

Atrophic / atrophic inflammationvagina (vaginal atrophy) - symptoms

  • vaginal dryness;
  • vaginal itching and itching as well as vulva itching;
  • incorrect vaginal discharge;

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  • tendency to the formation of petechiae and erosions of the epithelium, even with the slightest, minimal trauma to the vagina (due to dryness, it is more exposed to any damage);
  • pain and burning sensation when walking;
  • urinary tract problems: severe pressure on the bladder, pain while urinating, urinary incontinence, hematuria, pollakiuria;

In women who have intercourse, the following also appear:

  • dyspareunia, pain during intercourse;
  • vaginal bleeding or spotting after intercourse;

It is worth knowing that these symptoms are more pronounced in women with diabetes and in those who are very thin (women with low body weight have a reduced concentration of estrogens in the blood). The researchers' research also shows that in sexually active women, vaginal atrophy symptoms do not occur or are less severe than in women who are not sexually active. This is because blood flow to the pelvic organs increases during intercourse.

Important

Atrophic vaginosis should not cause spontaneous bleeding or spotting. However, if they do appear, you should go to the gynecologist as soon as possible. There is a risk of endometrial cancer being the cause.

Atrophic / atrophic vaginitis (vaginal atrophy) - diagnosis

During the gynecological examination, the doctor assesses the vaginal discharge, the continuity and thickness of the vaginal epithelium, the color of its walls, as well as the pH and cytological maturity index (describes the percentage of the main cell types of the subsequent layers of the vaginal epithelium: superficial, intermediate and basal).

Atrophic / Atrophic Vaginitis (Vaginal Atrophy) Treatment

The aim of the treatment is to supplement the estrogen deficiency, which is achieved thanks to hormone replacement therapy, which includes drugs used in appropriately low doses. It is not used in women who have had breast cancer, as oestrogens can stimulate the growth of cancer cells.

Vaginal moisturizing products with hyaluronic acid and lubricants work well in the case of small atrophic changes in the vagina. If the symptoms are very bothersome, the doctor may order the use of topical estrogens - in the form of creams, ointments or gels. They help to reduce vaginal dryness and itching, andalso enhance its flexibility. You can also use oestrogens in the form of vaginal rings. The effects are visible after a few weeks of estrogen therapy.

In addition, you should wear airy underwear and use preparations intended specifically for the hygiene of intimate places (it is absolutely necessary to avoid irritating hygiene products with an intense smell). In addition, you should give up smoking and exclude alcohol, chocolate, paprika or pepper from the menu, as they aggravate the symptoms.

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A postmenopausal woman diagnosed with atrophic vaginosis is more prone to genital and urinary tract infections (bacteria from the vagina can travel to the urethra). They are often diagnosed with Bartolini gland inflammation. Another common condition is vaginitis and vulvitis. It is most often caused by bacteria and viruses that easily reach the walls of the reproductive organs weakened by the lack of estrogen.

In addition, the muscles that support all organs of the reproductive and urinary systems are weakened due to the reduction in the level of estrogen in the blood. This can lead to the movement of the uterus, bladder and urethra, and even the rectum into the vaginal canal.

Category:

Female diseases