Vulvar atrophy (VVA, sometimes called atrophic vaginitis) is a physical condition that may explain any recent issues you may be having with painful intercourse in your intimate relationships. What is VVA? What does it mean if you have VVA?

VVA defined
VVA is a condition where the female inner genital walls become dry and inflamed, and is caused by low estrogen levels. Usually this happens during perimenopause and continues during postmenopause but some women may experience VVA while breastfeeding.

Having a dry and inflamed genital area often means painful intercourse and can affect your overall perception of yourself as a woman. Is there something wrong with me because I no longer enjoy my physical intimate relationships? Am I just getting older and I have to accept that part of my life is over? Does my partner think I no longer want to be intimate?

VVA symptoms
There are a number of health issues arising from VVA that can affect your overall genital health. Fluctuating acidic levels may lead to bacterial or yeast infections. You should watch for:
*Genital dryness, noticeable difficulty with intercourse or inserting tampons
*A burning sensation in the genital area
*Burning sensation while urinating
*Urgent need to urinate, some women become incontinent or have bladder leakage
*Painful intercourse, even bleeding after intercourse

What causes VVA?
You may notice some of the following symptoms:
*Perimenopause and increasing severity through to the postmenopause years
*While breast-feeding
*Surgically induced menopause
*Radiation and/or chemotherapy treatments for cancer
*Taking breast cancer hormone treatments

In addition, some factors may increase your risk of developing VVA. Smoking, an overall health menace, affects blood circulation, cell oxygen levels, and leads to genital dryness. Some studies suggest that women who have delivered their children by C-Sections, or women who never delivered a child, are more likely to develop VVA but there is still some debate as to why. Women who use scented bath products, douches, or hygienic sprays may also develop symptoms similar to VVA.

VVA and your doctor
You may be reluctant or embarrassed to talk to your doctor about having any of the above listed symptoms. It helps to write down the symptoms you are experiencing and frequency. Even just handing a sheet of paper to your doctor can help explain what is happening to you in a less embarrassing way, and start a meaningful conversation about your health. Once your doctor has an idea about your symptoms and lifestyle, he or she can use a pelvic examination, Pap test, and urine test to determine if you have VVA.

VVA diagnosis and treatment
For mild genital irritation, your doctor may simply recommend a topical cream to treat itchiness and burning. For a VVA diagnosis, topical estrogen creams or oral estrogen tablets can increase hormone levels. Your doctor may also suggest genital moisturizers or lubricants for use during intercourse to help alleviate any discomfort. Oddly enough, gynecologists point out that regular physical intercourse helps keep the genital area healthy by increasing blood flow, which in turn helps make physical contact less irritating and more pleasurable.

Never be embarrassed to talk to your doctor about VVA, and be sure to let your partner know. Keeping the lines of communication open means taking charge of your health and enjoying all aspects of your life that you wish to keep vibrant during and beyond menopause.

Need some more research info? Head to the Mayo Clinic Website at www.mayoclinic.com.

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