Vaginal dryness

With the hormonal changes that occur during the period leading up to menopause and once it has begun, it's normal for vaginal health to be affected. When your body produces less estrogen, there's a reduction in blood flow to the vagina, vulva, and even the clitoris, which can disrupt natural lubrication.

Vaginal atrophy is a condition in which the tissues lining the inside of the vagina thin, dry out, and become inflamed. As a result, these tissues become thinner, less elastic, and less moist. Additionally, the vaginal pH changes, and the flora can be altered, leading to more frequent infections. All of this can cause discomfort such as itching and irritation, which may be particularly pronounced during sexual intercourse.

The prevalence and severity of symptoms vary depending on the time elapsed since menopause. After the first year, approximately 65% ​​of women will experience vaginal dryness and atrophy, and six years post-menopause, this figure rises to 84%. Sometimes, patients normalize certain symptoms and do not seek medical advice. Currently, it remains an underdiagnosed and undertreated condition. It is crucial to emphasize the importance of asking patients about these symptoms during consultations so that they can be treated as early as possible and the impact on their quality of life can be mitigated.

Thanks to Regenerative Gynecology, we have various solutions for all these problems. Treatments that will allow you to regain comfort and confidence. The treatment plan must be tailored to each patient, individualized, and not static, but rather adapted throughout the patient's life to meet their evolving needs and clinical characteristics.

But…what do women know about genitourinary syndrome of menopause (GSM)?

The term genitourinary syndrome of menopause (GSM) is a more medically accurate, comprehensive, and acceptable term than vulvovaginal atrophy. It was first introduced in 2014, and is now the more professional way we refer to this condition.

It is a chronic and progressive disease that affects sexuality and quality of life. It is preventable and treatable. It will require long-term and often sequential treatment aimed at relieving symptoms. The most well-known treatments among women are lubricants, followed by local estrogens. And, surprisingly, studies indicate that up to 20% of women are unaware of any treatment options.

NON-HORMONAL TREATMENTS

Non-hormonal treatments include vaginal moisturizers, which help keep the vagina moist and supple. It is recommended to apply them daily, morning and night. They provide immediate relief, but they do not treat the underlying problem and do not repair the tissue.

On the other hand, there are vaginal lubricants; water-based ones are recommended and would be indicated in all sexual relations to reduce pain and friction.

We must bear in mind that the skin is a highly sophisticated biological structure containing, among other things, water from perspiration and lipids from natural sebum secretion. The presence of water and lipids in the skin is vital for its proper function and its ability to maintain homeostasis in the body. It is very important to select a texture and active ingredients with specific characteristics to achieve greater satisfaction and adherence to the prescribed treatment, alleviating symptoms and promoting proper recovery of the vulvar skin.

It is also well known that maintaining sexual activity helps prevent vaginal atrophy. An active sex life, along with vibration therapy, can also be beneficial, as it increases blood flow, lubrication, elasticity, and sensitivity in the intimate area, in addition to strengthening the pelvic floor muscles. All of this contributes to improved sexual function and overall well-being.

Exercises to strengthen the pelvic floor muscles will also help increase blood flow to the vagina, improving its elasticity and urinary function.

Furthermore, we have specific probiotics that act on the vaginal microbiota and, by improving the vaginal environment, improve these symptoms and prevent infections, compensating for the decrease in estrogen.

Among the non-hormonal treatments are regenerative treatments, among which perhaps the most prominent are gynecological laser and vaginal radiofrequency.

The gynecological laser will act on the vaginal mucosa, stimulating collagen production and improving blood circulation, which makes the vagina more elastic, hydrated, and healthy.

Radiofrequency is a non-surgical procedure that uses radiofrequency energy to stimulate collagen production and improve skin laxity and tone in the genital area, thus improving vaginal dryness and even urinary incontinence, pain during sexual intercourse, as well as vaginal sagging caused by aging.

We also offer hyaluronic acid therapy. Its injection is used to treat vaginal dryness and dyspareunia due to low estrogen levels.

LOCAL HORMONE THERAPY

Local hormone therapy for the treatment of vaginal atrophy due to estrogen deficiency in postmenopausal women should be the first choice and according to the criteria established by the Spanish Association for the Study of Menopause (AEEM) for eligibility of Menopause Hormone Therapy (MHT) it would be category 1. This category implies that there are no restrictions or that the benefits outweigh the risks.

The efficacy and safety of using local estrogens for the treatment of SGUM is more than proven, even in patients with a history of breast cancer, since systemic absorption is minimal.

Local estrogens have shown improvement in urogenital symptoms between two and four weeks after the start of treatment.

In conclusion, it should be noted that, for various physiological, preventative, and efficacy reasons, treatments that act on estrogen receptors should be considered first-line therapies. As a second-line treatment, and at any time, vaginal moisturizers and/or lubricants should be considered as complementary therapies, since these are effective for the symptoms but do not prevent or improve the underlying pathology. Finally, regenerative treatments, including laser therapy, vulvovaginal radiofrequency, and hyaluronic acid, among others, fall into a separate category.

Menopause and sexual health are no longer experienced the same way as before!

At Beldon Medical we are very committed to the health and well-being of women and we are very aware that vulvovaginal atrophy can be associated with serious symptoms and a significant deterioration in quality of life, which is why we promote appropriate clinical evaluation and early therapeutic intervention.