Vaginal atrophy: how to treat it

Vaginal atrophy is thinning and dryness of vaginal skin which usually happens after the menopause. It can also happen in women who exclusively breastfeed, take breast cancer medications or have recurrence risk-reducing intervention following breast cancer treatment such as removal of both ovaries.

Over the past ten years, treatment for this common condition has changed. We recently spoke with a leading London based women’s health expert and consultant gynaecologist Mr Mahantesh Karoshi to discuss vaginal atrophy, its symptoms and how it should be treated.

What causes vaginal atrophy?

Vaginal atrophy occurs when there is a decrease in blood's oestrogens level, it causes thinning of vaginal skin. It’s extremely sensitive to oestrogen levels, when the oestrogen levels drop, the cells of the vagina start getting shed off so the skin becomes thin.

What are the symptoms of vaginal atrophy?

Burning sensation, dryness, itching, and difficulty during sexual intercourse, vaginal spotting (losing blood) because the skin is so thin it breaks easily.

How can vaginal atrophy be treated?

Most commonly used interventions are vaginal moisturisers, they’re specifically made for vaginal skin. They’re similar to body moisturisers but adapted slightly. The drawbacks of vaginal moisturiser is that its temporary relief, women feel a bit messy, it can leak out or stain underwear. There are vaginal oestrogens, you can insert a pessary, cream or ring, and this can help relieve vaginal dryness but will not help with many of the other symptoms including hot flushes.

Women who have suffered breast cancer treatment don’t usually like to take anything with hormones because breast cancer is sensitive to hormone use, and it can affect the remaining part of the breast tissue. Most patients don’t take vaginal oestrogens, even if there are no contraindications, they’re reluctant to use them.

How else can it be treated?

Vaginal laser treatment, it’s the ‘new kid on the block’ so to speak. You may have seen or read that people that get it for laser facial treatment. Well, it’s also available for women’s vaginas that have vaginal atrophy. The history has been set as, A gynaecologist was a good friend of a skin specialist, one day he was talking about a woman’s vaginal atrophy and they decided to test the facial laser with a probe that can be inserted into a vagina.

It was developed by Professor Stefano Salvatore, a gynaecologist based in Milan, they ran a medical trial on female patients with breast cancer. This is how it started, more women used it and it slowly became more and more popular. The treatment has been around for roughly ten years.

If you’re currently experiencing symptoms of vaginal atrophy, make an appointment with top women's health expert Mr Mahantesh Karoshi via his Top Doctors profile today.