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Urogenital Atrophy
Menopause and vaginal health
Urogenital atrophy is a condition which most often occurs during and after the menopause. It is caused by a lack of oestrogen and leads to the thinning and loss of elasticity and reduction in mucus producing glands which affect the vagina, vulva, urethra and bladder.
It is quite common, with about 25% of women experiencing symptoms in the perimenopause and up to 50% of post-menopausal women.
Changes to the vagina
The vagina can become shorter and narrower due to a loss of fat in the surrounding tissues. With the thinning of the skin and loss of elasticity, the vagina can become inflamed and very tender - this is called vaginal atrophy. A woman may experience frequent vaginal infections and itching such as bacterial vaginosis (BV). Having intercourse can be extremely painful and sometimes impossible for some women.
Changes to the bladder
Experiencing frequency and urgency to pass urine is quite common. Some women also find it painful to pee. The risk of prolapse also increases with age which can affect passing urine.
Low desire
Because of the symptoms of urogenital atrophy, it can greatly affect how a woman feels about intimacy and sex. It can take a while to recognise when vaginal atrophy is affecting your sex life. You may gradually experience soreness during or after intercourse and eventually avoid sex altogether.
How you can address these issues
There are treatments for vaginal dryness and atrophy, mainly vaginal oestrogens (which is not to be confused with HRT) and vaginal moisturisers and lubricants.
Vaginal oestrogens:
Vaginal oestrogens are very safe and the vast majority are not absorbed into the body’s blood stream. They target the site of application and come in creams, pessaries and vaginal rings. These are normally applied directly into the vagina, and creams can also be applied to the vulval areas too.
It is normally used every day for the first 2 weeks and then reduced to twice a week to help replace the oestrogen that has been lost. The treatment should be used on a long term basis as stopping them will mean your symptoms will return. Vaginal oestrogens can also be used alongside HRT if HRT is not helping the symptoms.
Vaginal moisturisers and lubricants:
These have been specifically designed for intimate areas and can help to restore moisture and PH balance in the vagina, just like a moisturiser does on the skin. A vaginal moisturiser should be used regularly as directed on the packaging. Lubricants are usually used for more intimate times when additional lubrication is required.
There are many products available on the market and can be bought over the counter or at a pharmacy. Brands include:
- Pjurmed
- Yes
- Sylk
- Replense
- Hyalofemme
Oil based lubricants are better than water based products as they coat the vagina and last longer. Pjurmed offers a silicone based product which is very long lasting and is good for very sensitive vaginas.
Always check the product details for sensitivities/allergies.
Avoid products which contain perfumes and colourants as these can irritate intimate areas and potentially make symptoms worse.
Always check the products are safe to use with condoms - oil based products can cause rapid deterioration of latex condoms and cause them to break.
This is the eighth in our series on Menopause. Check out our other articles to get a full understanding of what the Menopause means for many women:
What is HRT (Hormone Replacement Therapy)?
Alternatives to HRT (Hormone Replacement Therapy)
What is Menopause Exactly?
Managing Anxiety During Menopause
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