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Vulvar atrophy and painful intercourse

Painful intercourse is a common menopausal complaint, one that is only now getting serious consideration from the healthcare community. In the past, women suffered in silence or endured labels such as ‘frigid’ or ‘old’ in matters affecting intimate relationships. New breakthroughs in research are putting women’s minds at ease; difficulties with intercourse are not all in our heads.

VulvoV*ginal atrophy (VVA or sometimes called atrophic vaginitis) is a physical condition and a component of overall painful intercourse issues and affects a greater number of women than previously thought. VVA is the thinning and inflammation of the inner female genital walls due to lower estrogen levels. This leads to painful intercourse.

Women in perimenopause, menopause, and postmenopause can develop VVA. A study that examined 1500 women showed women with lower estrogen levels often had lowered genital pH measurements, which indicated the presence of VVA. Up to 85% of the women exhibited signs of VVA, and even 15% of women using minimal levels of estrogen therapy experienced VVA.

The good news is that there is hope and help available.

One of the biggest obstacles to understanding VVA has been the reluctance on both patients and doctors to broach this delicate and sometime embarrassing subject. As Dr. Murray Freedman points out there are typically three factors that impact the quality of a woman’s intimate life: her age, hormone levels, and relationship issues that may be present prior to menopause or arise out of menopause and getting older.

VVA has been largely overlooked because previous focus concentrated on psychological complaints and treated intercourse as a matter of the heart and the head. Now obstetricians and gynecologists understand that physical symptoms may precede any emotional outcomes. Women may experience intercourse difficulties due to a physical matter that in turns affects women’s satisfaction with their intimate physical relationships. Address and treat the physical symptoms and you may be able to lessen or avoid the psychological attitudes surrounding menopause and aging.

In the past, women were given a cream or lubricant to help alleviate any genital dryness or redness. Now doctors have a better idea of VVA and that superficial topical treatments are no longer enough. New courses of treatments include a combination of estrogen therapy either in a localized topical cream or estrogen pills in addition to lubricants. This two-pronged approach ensures a more comprehensive treatment package to address both the physical and psychological issues surrounding painful intercourse.

Women no longer have to believe that there is something wrong with them or that getting older means the end of intimate relationships. If you are experiencing painful intercourse, talk to your doctor to learn more about the ways to help reclaim this part of your life.

Freedman, Murray A. MS, MD Department of Obstetrics & Gynecology, Medical College of Georgia, Augusta, GA, “Prevalence, Etiology & Diagnosis of Vulvov*ginal Atrophy” as presented at the 22nd Annual Meeting of the North American Menopause Society, Washington, D.C. 2011.

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