Vaginal Dryness
Vaginal Dryness is related to the Genitourinary Syndrome of Menopause (GSM) is an extremely common and previously under diagnosed and underrated condition affecting at least 50% of post menopausal women. Previously referred to as “ Vaginal Atrophy” it is now recognised that after menopause women commonly experience a number of symptoms related to the decrease in oestrogen levels due to the depletion of eggs in the ovaries.
Vaginal atrophy is part of this syndrome where the vaginal mucosa becomes progressively thinner, more fragile, irritable and more sensitive to trauma. For women, this means vaginal dryness and itching, painful intercourse and poor vaginal elasticity and tone. The pain associated with poor vaginal lubrication is often caused by micro-tears in the post-menopausal atrophic vagina and not surprisingly this lead to a decreased desire for intercourse.
Vaginal Relaxation Syndrome is also common and refers to the loss of optimum structural architecture of the vagina. As well as vaginal atrophy the vaginal muscles and vaginal collagen decline leading to a loss of sexual satisfaction.
Urinary incontinence is also a major part of the GSM. There is not only atrophy of the vaginal mucosa and vaginal muscles but also of the pelvic floor muscles leading to a “ tipping point” where previously manageable mild urinary symptoms transition into frank stress incontinence, and urinary urgency. The mucosal changes contribute to a change in the vaginal pH and urinary tract infections are also much more prevalent.
Previously these post menopausal genitourinary symptoms were either ignored by medical practitioners and dismissed as “ an inevitable part of ageing in women”. If treatments were offered, vaginal laxity was treated with vaginal surgical mesh procedures and urinary incontinence was treated with surgical vaginal mesh TVT tape insertion. Vaginal oestrogen creams were the mainstay treatment of vaginal dryness. Due to the high number of complications with vaginal mesh procedures, many women no longer wish to have surgery to treat their symptoms. Although vaginal oestrogen creams go partway to addressing the vaginal dryness and itching, again many women are reluctant to use an oestrogen cream for of HRT due to possible or perceived risks. Women who have had breast cancer may be advised by their treating doctors not to use any additional hormone treatments
Dr Sonya Jessup is passionate about helping women treat and manage their menopause symptoms, of which vaginal dryness is one of the most common symptoms. Book an appointment today.
