The Vagina Dialogues: Treating Vulvovaginal Atrophy

Remember that play that premiered a few years back called, “The Vagina Monologues”? Well, I wish someone would write one called, “The Vagina Dialogues” so that women would start to realize that it’s okay to talk with their doctors about their vaginas! As you know, menopause brings with it all kinds of changes to various body parts, including your vagina.  There’s a very common condition called vulvovaginal atrophy (referred to as VA in the medical world), in which the walls of the vagina become thin, dry, and possibly even inflamed due to a decline in estrogen. (The vulva refers to your external genital organs, including the labia and clitoris.) Symptoms of vulvovaginal atrophy include:
  • Vaginal dryness, irritation, or burning
  • Burning and/or urgency with urination
  • Urinary tract infections
  • Urinary incontinence
  • Discomfort and/or light bleeding after intercourse
About half of all postmenopausal women will experience some symptoms of atrophy. But often they’ll look at these signs in isolation, not realizing that a urinary tract infection may be directly related to the discomfort they feel during intercourse—and that both might be indicative of vulvovaginal atrophy. Although treatment is readily available, it has to be diagnosed first. But because women are often too embarrassed to talk with their doctors about vaginal problems, they don’t mention it during annual physicals, let alone pick up the phone when symptoms first concern them. Instead, they try to treat it themselves, guessing at what might work, not knowing there’s a name for what they’re experiencing. And while over the counter lubricants may offer some short-term relief for dryness, vulvovaginal atrophy is chronic and requires ongoing treatment to address the underlying cause. Typically, treatment for vulvovaginal atrophy involves some sort of estrogen therapy, in the form of a vaginal tablet or ring or topical cream. But the first step is getting a diagnosis. That’s why it’s so important to talk with your doctor about any changes you experience in your vaginal area. So please: Don’t be shy and don’t wait. Be proactive and bold when it comes to taking charge of your own body. As with many other parts of life, it’s much easier to maintain healthy tissues and organs than to treat problems long after they’ve begun. As soon as you feel anything unusual, lubricants don't seem to work as well, or you begin experiencing any of the symptoms listed above, make the call to your physician. And begin your own vagina dialogues, the sooner, the better.

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