Vaginal thinning occurs with an atrophy of epithelium of the vagina (vaginal atrophy) that results from reduced stimulation of estrogen hormone and also results in inflammation of lower UT and vaginal walls. This is a natural change observed in around 75% of postmenopausal women. But, it may also happen in a few women, after childbirth. Vaginal thinning may results in discomfort and vaginal itching, during intercourse.
The rise in life expectancy has put a severe impact of vaginal thinning on urogynecologic health, sexual functioning and overall quality of life. Even certain younger women and those in peri-menopause phase are seen to undergo periodic vaginal thinning and related problems. Vaginal wall thinning and change in vaginal acidity due to vaginal atrophy elevate the risk of vaginal infections.
Atrophic Vaginitis symptoms include itching and redness of the vagina. There could be shrinkage and narrowing of vagina and vaginal opening over a certain period of time. Vaginal thinning is accompanied by a number of symptoms that includes vulvar pain, internal and external irritation, vaginal pain, severe burning, vaginal itching, vaginal discharge and dyspareunia (painful intercourse). Women suffering from these may also have fear of digital and pelvic examinations.
The Root Cause Of Vaginal Thinning
Vagina depends majorily on estrogen hormone in order to remain healthy. As estrogen levels drop down during peri-menopause and post menopause, the vagina thins down with an increased risk of wear and tear, usually causing dryness, itching and burning. Due to lower lubrication, intercourse becomes painful and contributes more to the risk of vaginal tears and vaginal infections.
The vaginal infections have high chance of occurrence, since the natural acidic nature of vagina gets disturbed that normally protects vagina from fungal and bacterial infections. Moreover, estrogen is important for maintaining health of urinary tract that includes bladder, pelvic floor muscles and urethra. One may also experience bladder and urinary tract infections with urinary incontinence. The solution is to increase estrogen levels as per the severity of the situation.
Treatment Options For Vaginal Thinning Problems
Doctor initially analyzes the symptoms to analyze whether vaginal thinning is caused by an irritant, infection or decreased estrogen.
For mild symptoms, a water soluble lubricant can be applied over vagina, during intercourse. But, do not apply mineral oils or petroleum jelly as these may further increase chance of infection and can damage diaphragms and latex condoms.
For moderate symptoms, the doctor may prescribe vaginal cream containing estrogen, to reduce vaginal itchiness and dryness, and improve tissue elasticity of the vagina.
Transdermal application of vaginal cream is recommended for cases with severe symptoms, but for those with a history of breast cancer or other hormone sensitive cancers, this treatment option is not advisable.
Hormone replacement therapy (HRT) can also be performed for severe cases of vaginal atrophy or with extreme levels of vaginal thinning. HRT can be done by intake of tablet, application of gel, putting implant or patch that supplies estrogen to the body. Though, it is known to be very effective, but there remain risks for long term usage of this therapy.
There is an increased risk of breast cancer in women using this therapy. Even survivors of breast cancer are advised not to go for this therapy. Localized HRT can also be performed using creams, vaginal tablets and rings that have to be taken internally to assimilate estrogen in the vaginal area.
Sexual activity helps to promote vaginal pliability, elasticity and the lubrication needed for sexual stimulation. It is considered a healthy prescription for postmenopausal women, whose vaginal epithelium is substantially estrogenized. Women actively involved in sexual activity show less symptoms of vaginal atrophy like vaginal thinning, on getting examined. These women tend to show less evidence of shrinkage and stenosis, in comparison to other sexually inactive women.