Atrophic Vaginitis: Causes, Symptoms, and Treatments

atrophic vaginitis

What is Atrophic Vaginitis?

Atrophic vaginitis, commonly referred to as vaginal atrophy, is a medical condition characterized by the thinning of the walls of the vagina and becoming dry and inflamed. Most cases of atrophic vaginitis are among women whose estrogen levels are low, often resulting from menopause, breastfeeding, or some treatments. Such women experience loss of their natural lubrication and elasticity in the tissues of the vagina, hence resulting in discomfort and pain during intercourse; and most typically, the risk of infection. Many women are shy to discuss their signs, thereby delaying treatment and worsening symptoms over time.

What Causes Atrophic Vaginitis?

The main cause of atrophic vaginitis is low estrogen levels, which is the essential hormone in maintaining healthy, thick tissues for vaginal and urethral tissues. Some common causes of hormonal change include the following:

  • Menopause: The most prevalent cause of estrogen decline in females.
  • Postpartum and Breastfeeding: For some women, estrogen drops temporarily during this period of time, causing vaginal dryness.
  • Certain Medications: Chemotherapy, radiation, and hormone therapy for breast cancer deplete estrogen.
  • Surgical Removal of Ovaries: When both ovaries are removed, the estrogen level drops drastically and leads to atrophic vaginitis in some women.

Who is at Risk?

Atrophic vaginitis mainly occurs in postmenopausal women, but also some younger women may experience it due to certain life situation factors, diseases, or treatments that place them at more risk. The risk factors include:

  • Smoke, as smoking destroys blood flow and destroys hormone balance
  • No vaginal delivery, as that puts one at higher risk.
  • Infrequent or avoidance of sexual activity, which may give way to causing dryness and discomfort in the vagina

Symptoms of Atrophic Vaginitis

The symptoms of atrophic vaginitis vary and worsen if not treated. The most common symptoms are as follows:

  • Vaginal Dryness: Lack of lubrication is a source of discomfort.
  • Burning Sensation: This can either be internal in the vagina or external.
  • Itching: Irritation and itching in the vaginal area.
  • Pain during Intercourse: Mainly due to lack of lubrication.
  • Urinary Symptoms: Increased frequency, urgency, and burning during urination.
  • Spotting or Bleeding: Light bleeding, especially after intercourse.

Most women confuse these symptoms for infections; however, if they persist for a long period, it is crucial to see a health provider to determine the cause.

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How is Atrophic Vaginitis Diagnosed?

A diagnosis of atrophic vaginitis is often made after a detailed medical history, and performing a pelvic exam. Sometimes, multiple different signs include thinning or reddening of the vaginal walls, and sometimes a swab or sample of vaginal discharge is obtained for ruling out infections or other causes.

Blood tests are rarely necessary, but may be done to assess hormone levels if it is an undetermined diagnosis.

Treatment Options for Atrophic Vaginitis

Lifestyle and Home Remedies

  • Moisturizers and Lubricants: Over-the-counter vaginal moisturizers can be a source of hydration to reduce dryness, whereas lubricants are useful before sexual activity to reduce pain and friction.
  • Regular Sexual Activity: Sexual activity or use of vaginal dilators can help preserve elasticity in the vagina.
  • Pelvic Floor Exercise Pelvic: floor strengthening can be reinforced by Kegel exercises, and they can be expected to prevent further atrophy and increase sexual comfort.

Topical Estrogen Therapy

  • Creams, Rings, and Tablets: The use of topical estrogen therapies delivers medication directly to the tissues of the vagina, and local application is typically safe for most women since it results in minimal systemic absorption. They can replace natural moisture and elasticity.
  • Advantages and Disadvantages: These therapies provide localized relief with fewer side effects than systemic HRT. They are not suitable for women with hormone-sensitive cancers.

Systemic Hormone Replacement Therapy (HRT)

  • Systemic HRT, including pills, patches, or injections, may be prescribed for women with more severe menopausal symptoms to address more generalized hormonal symptoms, like atrophy.
  • Risks: Systemic HRT has been linked to increased risk of breast cancer, blood clots, and several other conditions. So it’s not prescribed for atrophic vaginitis alone.

Non-Hormonal Medications

  • Selective Estrogen Receptor Modulators (SERMs): Agents such as ospemifene are similar in action to estrogen on the vaginal tissues but are not a systemic form of HRT. They are used in patients for whom regular estrogen therapy is contraindicated.

Emerging Treatments

  • Laser Therapy: This treatment focuses on using concentrated light energy to promote the production of collagen as well as to stimulate the healing processes in the vaginal tissues. This is a promising approach, and more research would be necessary to establish safety and effectiveness for more extended periods.
  • PRP (Platelet-Rich Plasma): Injections of PRP into vaginal tissues are believed to trigger repair and regeneration of tissue, although studies are still needed to confirm this treatment’s effectiveness.

Herbal and Natural Remedies

  • Phytoestrogens: These plant chemicals have estrogen-mimicking properties and can be found in soy, flaxseed, and other herbs. While extremely mild, they may help alleviate symptoms for those seeking natural remedies.
  • Vitamin E: Applying vitamin E oil to the skin may help lubricate the vagina.

Prevention of Atrophic Vaginitis

While some cases of atrophic vaginitis are inevitable due to the onset of menopause, the degree of susceptibility and diminution of symptoms can be placed in the hands of women. Minimal lifestyle changes and self-care may be able to support vaginal health to maintain moisture and prevent further irritation.

Avoid Using Harsh Soaps And Chemicals

The skin lining the vaginal area is sensitive and may become even more sensitive due to the usage of strong, fragrant soaps or other perfumed products. Instead, one should use mild unscented soaps and avoid using douches or sprays with chemical substances that are known to disrupt the natural pH balance of the vagina. This will enable one to reduce the chances of developing symptoms of atrophic vaginitis. It keeps it comfortable without any unnecessary irritations.

Wear Breathable Underwear

Selecting the right underwear may also play a great role in keeping healthy vaginas. Cotton underwear can breathe or permit the air to circulate in between it, and reduces the buildup of moisture preventing irritation and infection. Wearing loose, light-fitting underwear can be very comfortable, especially for those who have very active lifestyles or those residing in warm places.

Get Physically Active

Routine exercise enhances the total blood circulation throughout the body and promotes vaginal health because it stimulates the pelvic area’s blood flow. Proper circulation maintains tissue health, which prevents atrophic vaginitis symptoms. Some good examples include walking, cycling, or any other version of yoga exercises that will help ensure an active and healthy lifestyle.

Quit Smoking

Smoking is a risk factor for atrophic vaginitis since smoking causes a reduction in the level of estrogen in the body. Estrogen is vital for maintaining healthy vaginal tissue; therefore, its reduction will make the vaginal walls susceptible to dryness and thinning. Smoking cessation preserves estrogen levels and prevents atrophic vaginitis symptoms from developing.

Preventive measures mentioned above enable women to keep under control, and sometimes even reduce the common symptoms associated with atrophic vaginitis, consequently allowing them to remain more comfortable and also improve their vaginal health regardless of age and hormonal changes.

Impacts on Daily Life Due to Atrophic Vaginitis

Atrophic vaginitis can severely affect lifestyle and comfort, not just from the body but also from a psychological and sexual aspect. Vaginal tissue becomes thin and very dry, causing any slight irritation that may cause itching or pain in sexual intercourse. The problem can become unbearable, difficult, and strain intimate relationships where frustration is felt by one partner who cannot continue with his usual physical intimacy.

Atrophic vaginitis may lead to urinary symptoms other than physical manifestation. Such symptoms include urgency and frequency or even low-grade incontinence. Many women find such symptoms embarrassing and do not move about socially or physically as they once did, and may avoid even traveling, all of which greatly impacts personal sociality and freedom. Nocturnal urinary symptoms can also interfere with sleep, along with fatigue and lifestyle interference.

Atrophic vaginitis is also challenging emotionally. For certain women, these types of changes in vaginal health reflect bigger changes that characterize aging, menopause, or certain medical treatments. These may therefore reduce self-esteem. Symptoms can lead women into a sort of disconnection from their bodies or distress over a loss of femininity and sexual confidence.

Fortunately, the therapies are all widely available, ranging from hormonal and non-hormonal therapies to lifestyle adjustments and other types of supportive therapies, such as pelvic floor exercises. Most women can be returned to comfort, sexual enjoyment, and confidence by open and honest communication with health providers and the development of an individually suited treatment program for the symptoms. Women with atrophic vaginitis can enhance the symptoms, quality of life, and maintenance of fulfilling relationships and activities without any losses of comfort or emotional well-being by seeking support and appropriate care.

Pelvic Floor Exercises

The pelvic floor exercises, especially the Kegel exercises, are very helpful in keeping in check both urinary and vaginal health. The pelvic floor comprises muscles that support the bladder, uterus, and bowels, thus regulating urination and supporting the pelvic region. Regular pelvic floor exercises will maintain the proper blood circulation to the pelvic region, which might help ease certain symptoms of atrophic vaginitis, such as dryness and discomfort in the vagina. Richer blood flow can help one retain a healthy and elastic tissue, thus making pain and irritation due to a thinning vaginal wall more tolerable.

However, the consistent and proper doing of Kegels is a challenge. Here comes the utility of Elitone, an at-home medical device that has been FDA-approved. Elitone provides a hands-free means of performing Kegel exercises. In other words, with this medical device, you can strengthen your pelvic floor muscles without having to contract and relax them actively. The patient uses low-level stimulation to gently contract the muscles to have it work effectively as if doing Kegel exercises.

Elitone can improve the muscle tone and increase the level of blood flow throughout the vaginal region. All of these may help reduce symptoms while better-strengthened muscles might help in improved urinary control, thus reducing leaks or urgency-other issues that could come about as the pelvic floor weakens. Using a device like Elitone provides supportive, consistent pelvic health. This allows women to better manage their symptoms, and enhance overall vaginal health, quality of life, and comfort.

Regular pelvic floor exercises, with or without Elitone, may prove useful in the management of atrophic vaginitis and the maintenance of long-term vaginal wellness.

Final Thoughts

Atrophic vaginitis is a very common, curable condition that most women experience after menopause. Early diagnosis and treatment are essential elements in minimizing discomfort as well as complications. Thus, women should consult a healthcare provider to discuss existing options. While hormonal therapies, lifestyle changes, or non-hormonal treatments may effectively alleviate atrophic vaginitis, pelvic floor exercises in combination with products such as Elitone can also prove helpful.

References:

  1. Shelley A. Flores (2022). Atrophic Vaginitis. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK564341/
  2. Camil Castelo-Branco (2005). Management of post-menopausal vaginal atrophy and atrophic vaginitis. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/16139449/
  3. G A Bachmann (2000). Diagnosis and treatment of atrophic vaginitis. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/10839558/
  4. Arum Lee (2018). Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/29765921/
  5. Catherine Lynch (2009). Vaginal estrogen therapy for the treatment of atrophic vaginitis. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/19788364/

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