Low estrogen may occur in women over 40, which is also a sign of the transition stage towards menopause, called perimenopause. But did you know a drop in estrogen levels can occur in women at any age after puberty? As estrogen levels reduce, changes to a women’s vaginal wall can result and bring discomfort. Living with vaginal discomfort doesn’t have to be the answer. At-home vaginal atrophy treatments and remedies do exist.
What’s Vaginal Atrophy?
As your body has less estrogen, a type of vaginal symptom of genitourinary syndrome of menopause (GSM), vaginal atrophy, can result. Vaginal atrophy is an under-reported and undertreated condition causing but not limited to vaginal dryness, thinning, or irritation.
Clinical terms associated with vaginal atrophy are vulvovaginal atrophy and atrophic vaginitis. These terms are slowly becoming less popular in the medical community as they are not the actual signs and symptoms that impact the genitourinary system during menopause.
Vaginal Atrophy Symptoms
Women who have vaginal atrophy commonly experience a variety of symptoms like shortening or tightening of the vaginal canal, vaginal dryness, itching, discomfort, and painful intercourse. Interruption in sleep, changes in mood, vaginal redness, and a burning sensation to the vaginal area are also reported. In an online survey conducted in the United States of 3,046 post-menopausal women with vaginal atrophy, dryness is the most commonly reported symptom in 55-83% of women, pain during intercourse 42%, soreness and itching 25-30%, and burning 14%. The impact of vaginal dryness and pain during sex is underestimated as a sexual dysfunction and many women face difficulties in their relationships and quality of life. They are not to be taken lightly but are treatable, not incurable.
Vaginal Atrophy Causes
What causes vaginal atrophy?
When less estrogen occurs, the vaginal tissues begin to thin, get dry, and have less elasticity. Overall, the vagina becomes more fragile or sensitive than normal. Although low estrogen is seen in women over 40 or in menopause, it also is diagnosed in young contraception users, after breast cancer, or postpartum. Therefore, causes may occur:
- While breastfeeding
- If taking medications (prescription, over-the-counter, allergy, birth control)
- When the body begins to transition to menopause (perimenopause)
- Following menopause
- After removal of both ovaries (via surgery)
- During and after radiation therapy or chemotherapy (for cancer)
Managing Vaginal Atrophy
Can vaginal atrophy be reversed?
Thankfully, there are options for managing and treating vaginal atrophy – it is no longer considered a permanent condition. Treatments exist to overcome the symptoms and supplement the loss of estrogen, which provide relief from vaginal atrophy. Options include but aren’t limited to:
- Oils, lotions, and lubricants: Although these aren’t intended to restore vaginal elasticity or thinning, these are commonly suggested to help alleviate the dryness and bring more comfort during sex. Avoid the use of Vaseline for vaginal lubrication as it is shown to increase the chance of vaginal yeast infections.
- Hormone therapy: Clinically shown to improve symptoms, hormone therapy also brings restores the thickening of the vagina skin and pH balance. Hormone therapy is not for everyone and comes with risks and costs. It will require evaluation and discussion with your doctor.
- Vaginal trainers/vaginal dilators: Research has shown that the use of these tools to help stretch the vagina and restore vaginal elasticity will help address painful intercourse. When used in conjunction with hormone therapy, relief of vaginal atrophy symptoms can be even more effective.
- Pelvic floor physical therapy: Specialists and pelvic health rehabilitation centers help decipher symptoms from pelvic floor dysfunction and vaginal atrophy. Getting a proper diagnosis and an appropriate treatment plan for at-home management will help with persistent issues. Specialized healthcare professionals give guidance on effective remedies (like vaginal trainers/vaginal dilators or hormone therapies) and techniques (meditation, pelvic floor exercises, treatment plans, etc.) to effectively manage the symptoms of vaginal atrophy.
Natural, Home Remedies for Vaginal Atrophy
Vaginal atrophy symptoms don’t have to be restricted to treatment inside a medical office or be overly-medicated. At-home remedies exist for managing mild symptoms. Here are a handful to start with:
- Education on the impacted lady parts: Familiarize yourself with your vagina. Grabbing a mirror and isolating the areas of your vagina feeling the most impact is a good place to start. For example, the vulva is often where dryness and irritation occurs. Here’s a video by Dr. Anna Cabeca, a board-certified gynecologist and obstetrician and expert in women’s health. She covers what the vulva is, if it looks “normal”, and how to keep it staying healthy.
- Adjust your eating habits and food types: There are a handful of essential fats and healthy foods to help foster vaginal health. Probiotic-rich food, fermented foods, and healthy fatty foods all contribute to healthy, natural vagina care.
- Avoid unnecessary toxins to your vagina: It’s important to read the labels on anything and everything that goes in or around your vagina. With so many over-the-counter moisturizers and lubricants on the market, be careful not to worsen your symptoms. Instead, try and find natural vaginal moisturizers that protect or nurture your body back to normal. According to Harvard Health, water-based vaginal moisturizers release water and help give a moist film over the vaginal tissue and restore pH levels. When considering lubricants, there are studies that show the altering of the vagina’s natural pH balance, which can lead to infections. Take it easy on your vagina. There are water-based lubricants and saliva as natural, simple options.
- Stimulate blood flow through the vaginal tissues: Use it or lose it is an applicable statement for achieving intimate health. If sexual activity isn’t an option, consider a vaginal trainer/vaginal dilator to help keep the pelvic/vaginal muscles stretching. Vibrators will help with relaxation and blood flow. All-in-one vaginal trainers like Milli have built-in vibration and will help with pelvic floor muscle stretching, vaginal stimulation, and overall pelvic/vaginal muscle relaxation.
Vaginal Dilation Therapy
In a 2016 publication from The National Center for Biotechnology (NCBI), vaginal dilators are recommended as effective, simple, non-hormonal intervention to alleviate specific vaginal atrophy symptoms like vaginal narrowing, loss of lubrication, and pain during sex (dyspareunia). Vaginal dilators/vaginal trainers are tools used in vaginal dilation therapy. This type of therapy is done at-home with daily, frequent sessions. Just like anything new, one or two sessions with a pelvic floor physical therapy may help with progress and practical guidance. Vaginal dilators are often prescribed to help decrease anxiety and help with specific symptoms of vaginal atrophy. Each brand is different and most are easily purchased online. They exist in many forms like plastic, latex, and silicone material and come as single sizes purchased individually or as incremental-sized sets. If looking for a more comfortable, convenient option, consider vaginal trainers/vaginal dilators with built-in incremental sizing for single insertion throughout each session. Few exist on the market but they do exist! Take care in considering what vaginal trainer/vaginal dilator will offer the most comfort, convenience, and control for managing vaginal atrophy symptoms.
Simple, accessible remedies exist for vaginal atrophy. If you decide to independently manage vaginal atrophy symptoms at home, be patient throughout the process. Managing symptoms may take time and daily diligence. This blog is not intended to supplement the guidance of your healthcare provider. Monitor your symptoms and talk with your doctor if they persist or worsen.
Information in this blog is for educational purposes only and not intended to replace medical diagnosis or advice from a health care professional. Patients are encouraged to seek a medical appointment for their evaluation of pelvic pain.