UROGENITAL ATROPHY
What is urogenital atrophy?
Urogenital atrophy, or atrophic vaginitis, is very common in women who are in menopause. Menopause is when a woman no longer has periods. During this time there are many hormone changes that happen. One of these hormones is called estrogen. Estrogen levels are low in menopause. This causes the tissue around the vagina to become dry and thin. This is called urogenital atrophy.
Estrogen levels can also be low if you:
• Have had your ovaries removed
• Are breastfeeding
• Had breast cancer treatment
• Are taking certain medications
What are symptoms of urogenital atrophy?
Women with urogenital atrophy may experience:
• Vaginal dryness, even during sex
• Painful intercourse
• Itching
• Stinging, burning vulvar or vaginal pain • Spotting (bleeding)
• Thin yellow or grey watery discharge
• Need to urinate more often
• Urinating more often overnight
• Leaking or losing control of your bladder (urgency incontinence)
• Many urinary tract infections (UTIs)
Many women that have these symptoms will not tell their doctor. This may be due to some of the following reasons: embarrassment, the belief that these changes are just “part of getting older,” that these symptoms aren’t important, or because they are trying home-remedies. It is important to talk to your doctor about these symptoms. There are many ways to treat these symptoms.
Are there tests to find out if I have vaginal atrophy?
Your doctor will usually diagnose atrophy by asking you about your symptoms and doing a physical exam. Your doctor will look for changes of the vagina and the vulva (the outside area around the entrance to the vagina). It is possible to test for atrophy by measuring vaginal pH – or the acidity of the vagina. If the vagina is less acidic than expected, or at a pH of more than 4.6, this shows vaginal atrophy. Your doctor may take some swabs of your vagina to rule out other causes of your symptoms. The most common vaginal infections that can have the same symptoms as vaginal atrophy are yeast infections or bacterial vaginosis (overgrowth of bacteria).
What are the treatment options?
You have 2 options for treatment:
-
Hormonal treatments
-
Non-hormonal treatments
What are the hormonal options?
The goal of hormone treatment is to put estrogen back into the vagina to treat the symptoms of low estrogen. Because it is placed only in the vagina, it is very safe. It is also the most effective treatment for atrophy.
There are different ways to put estrogen in the vagina:
• Vaginal cream
• Vaginal tablets
• Vaginal rings
Most often you will place the medication in the vagina every night for 2 weeks. After this, you can use the medication every 3 to 4 days.
There are some side effects to the medications. Ask your doctor if this medication is right for you.
I don’t want to take hormones. What are non-hormonal options I can use?
There are non-hormone medications that can help to moisturize and lubricate the vagina. They are safe and have few side effects. For these to work, you need to use them regularly: several times per week. They can also be used together with vaginal estrogen treatments. There are water-based and silicone-based vaginal moisturizers and lubricants. Ask your doctor if these are good options for you.
Where can I get more help or information?
Ask your gynecologist for more information. There are also many online resources that you can contact to get more help or more information:
Healthline – Postmenopausal Atrophic Vaginitis
healthline.com/health/atrophic-vaginitis
Society of Obstetricians and Gynecology – Menopause Resource
menopauseandu.ca
Start Talking Vaginal Atrophy
starttalkingva.ca
Sunnybrook Health Sciences Centre
2075 Bayview Avenue Toronto, ON M4N 3M5
Telephone: 416.480.6100
PR xxxxx (Feb 2017)
