Vulvovaginal atrophy.

Vulvovaginal atrophy (VVA) is a common condition in menopausal women. It is most commonly caused by decreased estrogen levels which affects the vaginal tissue. This tissue becomes thin, pale, dry, friable and inflamed. Women will often complain about vaginal dryness, decreased lubrication and/or pain at the vaginal entrance. Other symptoms include pruritis (itchiness), bleeding, urinary urgency and recurrent UTIs (urinary tract infections).

According to NAMS (North American Menopause Society) an estimated 25%-50% of postmenopausal women suffer from VVA, which equates to about 32 million women in the US. Data suggests that only 7% of these women are being treated, a very sad statistic. There is no need for women to suffer.

VVA can have significant negative effects in quality of life, on partner relationships as well as with a woman’s self-image and self-esteem. Over time, all of these negative effects add up and can spell disaster for a woman’s sex life.

Luckily, there are plenty of treatment options available these days. There are estrogen based creams, gels and vaginal rings formulated to restore balance in vaginal tissue locally. There are also plenty of options for systemic estrogen replacement therapy (ERT); patches, vaginal rings, and sprays that can help treat other symptoms of menopause including hot flashes, night sweats, insomnia etc.

Unfortunately, not all OB/GYNs take the time to discuss sexual health, especially if the patient doesn’t bring up the subject first. I am always amazed at the stories I hear from our patients. A practitioner may notice atrophy but since the patient didn’t complain of any symptoms the atrophy may be left untreated until their next appointment which may be in 3 years (based on the new Pap smear guidelines)! So, I encourage women everywhere to speak to your OB/GYNs or other practitioners about your sexual health. Effective and simple treatments are available. You may feel embarrassed at the time but that feeling is only temporary. Your vagina is worth it.

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