Vaginal atrophy (atrophic vaginitis) is characterized by thinning of vaginal walls, dryness and swelling that can result in painful sexual intercourse and urinary problems. The condition is caused by decreased estrogen levels and occurs most often after menopause.
However, estrogen levels can also drop because of chemotherapy, radiation, rigorous physical activity, depression, extreme anxiety and certain medications. In can also happen after giving birth and while breastfeeding, but the effects are milder and temporary.
Vaginal atrophy can also occur after surgical removal of the ovaries. Estrogen plays a significant role in vaginal and urinary health. When levels decrease either naturally or artificially, the effects can be very uncomfortable.
Vaginal atrophy tends to be associated with a deficiency of estrogen. This causes vaginal tissues to become thinner, less elastic and more fragile, and reduces the vagina’s ability to self-lubricate.
Women often experience vaginal atrophy during and after menopause, as this is when estrogen levels begin to significantly drop. Women who have had a hysterectomy, in which both ovaries are removed, are also at risk of vaginal atrophy because they subsequently go through what is known as surgical menopause.
Some women experience vaginal atrophy after having chemotherapy treatment for cancer, or radiation therapy in the pelvic region for cancers in that area. This is because these treatments can interrupt the body’s natural production of estrogen. Similarly, women who are taking tamoxifen, a medication which treats breast cancer and prevents breast cancer in those with a high risk, are more likely to develop vaginal atrophy because their estrogen levels will be reduced.
Smoking is also a factor which can increase the risk of vaginal atrophy, because it can reduce estrogen levels and affects blood circulation, which can prevent vaginal tissues from getting adequate oxygen for normal function. It is also known that women who have never had a vaginal birth, or have not had any sexual activity, could be at an increased risk of vaginal atrophy.
Sexual activity is a natural way to treat the vaginal atrophy. Increased blood flow to the genital region will help to generate and maintain healthy vaginal tissue.
Hormone replacement therapy (HRT) could be an effective way to prevent vaginal atrophy because it works to maintain high levels of estrogen. However, it is not without side effects and is known to increase the risk of other pelvic conditions, such as uterine polyps.
Regular sexual activity during and after the menopause is known to help reduce the severity of vaginal atrophy, because it can help to maintain vaginal elasticity and natural lubrication. However, it does not do anything to help increase estrogen levels in postmenopausal women.
Vaginal moisturizers and lubricants may help to alleviate dryness and discomfort for peri- or postmenopausal women, but they won’t necessarily prevent it. These may be particularly helpful for women who do not want, or are unable, to undergo hormone replacement therapy.