What is it?
Vaginal atrophy is a chronic condition characterized by thinning of the vaginal mucosa, resulting in reduced vascularity, elasticity, and degree of hydration. In addition, it is characterized by an increase in vaginal pH that results in a reduction in lactobacilli, and a subsequent increase in vaginosis.
The cause is the decrease in estrogen that occurs during manopause; the latter may be natural, premature, or iatrogenic as a result of surgery, chemotherapy, or radiation therapy.
Which are the symptoms?
Vulvo-vaginal atrophy symptoms are present in more than 50 percent of postmenopausal women, with a major negative impact on quality of life and sexuality.
- vaginal dryness
- vaginal itching
- dyspareunia: pain during intercourse
- recurrent vaginal infections
- increased frequency of urination
- urinary incontinence
How is it diagnosed?
The diagnosis of vulvar vaginal atrophy is mainly clinical. An important factor is the time of the anamnesis, i.e. in-depth investigation of the symptoms reported by the patient, the intensity and the impact on the quality of life. A simple but effective diagnostic tool is the use of validated questionnaires provided to the patient. Finally, the clinical examination is based on the vaginal health index, which evaluates the state of the vaginal mucosa.
How is it treated?
The purpose of treating vulvovaginal atrophy is to restore the state of the genital mucosa and thus improve symptoms. There are different kinds of treatment: hormone therapy, non-hormone therapy, laser treatment. Hormone therapy consists of applying estrogen-based creams locally; this is the first line of treatment recommended by guidelines if no contraindications are present. In case of hormone-sensitive tumor (breast cancer), hormonal therapy is not really indicated, so we can recommend the use of treatments with lubricating creams based on hyaluroninc acid and local moisturizers or CO2 laser vaginal treatment. The latter consists of an outpatient procedure, painless for the patient, without absolute contraindications or side effects. It has the function of restoring elasticity and lubrication to the vaginal walls thus improving symptoms such as vaginal dryness and pain during intercourse. Generally, there are 3 treatments at a distance of one month from each other, and the path is obviously customized for each patient.
Where do we treat it?
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