The CLarifying vaginal atrophy’s impact On SEx and Relationships (CLOSER) survey was conducted in South Africa in 2016. The survey aimed to gain insights into vaginal dryness and its negative effects on sex and relationships in menopausal women. So what exactly is vaginal atrophy and why does it affect so many menopausal women today? We sat down with Dr Trudy Smith, a Johannesburg gynaecology oncologist and obstetrician, who shared with us everything we need to know about vaginal atrophy.
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It sounds so scary. What is it?
Vaginal dryness is common after menopause. The symptoms can include painful intercourse, itching or burning, vaginal discomfort and frequent urination. It’s not easy to talk about, but it’s totally normal, and more common than you might think. It is estimated that 50% of women experience symptoms of a dry vagina after menopause, so you’re not alone.
What causes vaginal atrophy?
The hot flushes and night sweats of menopause resolve over time, but the symptoms associated with vaginal dryness may get worse and frequently require treatment. Vaginal discomfort after menopause occurs because the ovaries no longer produce enough oestrogen, the hormone responsible for maintaining the vaginal wall.
‘Before menopause the vaginal wall is thick and moist. After menopause, as oestrogen levels decline, it becomes thinner and dry. The blood flow to the vaginal tissue decreases, and the vagina secretes less fluid during sex,’ explains Smith. ‘The dry vagina is more prone to small injuries and infection.’
Do I just have to live with it or is there something I can do about it?
Vaginal dryness can be helped by simple lubricants, but a good option for treatment is to use local oestrogen. ‘Oestrogen therapy may be local or systemic, but local is preferred when symptoms of menopause are limited to the vaginal area,’ says Smith.
‘Local oestrogen therapy is administered directly into the vagina, and can be given as either vaginal tablets, a cream or a ring.’ Local oestrogen therapy can be an effective and logical treatment option for vaginal dryness, because only small doses of oestrogen are needed to treat the vaginal symptoms of menopause. The vaginal response to local oestrogen therapy can be quick and long-lasting, if it’s used as indicated.