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Is Your Vagina Dying? There's a Guide for That!

Tim Boyer's picture
Vaginal health care

Vaginal atrophy - also known technically as atrophic vaginitis or more colloquially as “a dying vagina”—is a common problem faced by up to 50% of all postmenopausal women.

However, according to a new review created by the European Menopause and Andropause Society (EMAS), there is hope for women who suffer from this condition that can be found in their clinical guide on low-dose vaginal estrogens for postmenopausal vaginal atrophy that includes a summary of recommendations. EMAS is advertised as “An international society that advances midlife health and beyond in women and men promoting the translation of science into clinical practice” that has a focus on hormone-related health issues and research.

Vagina atrophy is the thinning and inflammation of the inner walls of the vagina that typically develops due to a decrease in estrogen levels.

Decreased estrogen levels can occur:

• During breast-feeding
• During the years just before menopause (perimenopause)
• After menopause
• After surgical removal of both ovaries
• After pelvic radiation therapy for cancer
• After chemotherapy for cancer
• As a side effect of breast cancer hormonal treatment

Symptoms of vaginal atrophy include:

• Vaginal dryness
• Vaginal burning
• Burning with urination
• Urinary tract infections
• Urgency with urination
• Urinary incontinence
• Shortening and tightening of the vaginal canal
• Discomfort with intercourse
• Light bleeding after intercourse

The bane of vaginal atrophy is that for many women it makes sexual intercourse very painful, which can then lead to a decreased interest in sex to the point of total abstinence for the rest of their lives and thereby becomes not just a health issue, but a quality of life issue as well.

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Medical issues can arise as well secondary to vaginal atrophy. With vaginal atrophy, a woman is at an increased risk of developing vaginal infections from yeast, bacteria and other organisms. Furthermore, if left untreated, vaginal atrophy can contribute to urinary problems such as increased and painful urination with burning and/or incontinence.

Typical treatment for vaginal atrophy requires one of several forms of estrogen therapy—all of which have their pluses and minuses and contraindications for certain women. To help women research and decide with their doctor their best course of treatment, an up-to-date guide has recently been created by the European Menopause and Andropause Society.

In a recent press release issued by the scientific and medical publishing company Elsevier, they report that the current issue of the scientific journal Maturitas contains an article titled "EMAS clinical guide: Low-dose vaginal estrogens for postmenopausal vaginal atrophy" written by authors associated with the European Menopause and Andropause Society. The article is part of the EMAS guideline on vaginal atrophy.

The article addresses their review of treatments for vaginal atrophy and reveals that low-dose vaginal estrogens are effective for treating vaginal atrophy and that there is no need for added progestogens for endometrial protection if topical estrogens are used in the recommended doses—an important consideration involving the concern of hormone replacement therapy (HRT) and the risk of cancer. The article also provides other information and recommendations that are part of the guide created by EMAS.

For more information related to midlife (and beyond) healthcare that deals with hormone-related issues such as “a dying vagina” and other conditions, visit the EMAS website for current research and useful information that is also now available via Twitter.

Image Source: Courtesy of MorgueFile


“EMAS clinical guide: Low-dose vaginal estrogens for postmenopausal vaginal atrophy” Maturitas Volume 73, Issue 2 (October 2012); Margaret Rees, et al.

European Menopause and Andropause Society