Vaginal atrophy is a condition where the vagina becomes dry and constricts, making sex and pelvic exams difficult or impossible. Atrophy usually occurs after a woman has natural or surgical menopause, but it can also be a side-effect associated with chemo or radiation therapy for certain gynecological cancers. There are different treatments used to minimize the impact of vaginal atrophy on your life.
Estrogen is the hormone that is responsible for adding moisture to the vagina and keeping the muscles in good condition. When estrogen levels drop, it affects the vagina. One approach to managing vaginal atrophy is to supplement estrogen. Generally, women with a history of breast cancer may be advised against the supplementation of estrogen because it may trigger future incidents of cancer. There are different options if you choose hormone therapy. You can take systemic hormone replacement or you may have estrogen placed into your vagina to minimize the amount of estrogen in your bloodstream while receiving benefits. Estrogen therapy that can be inserted into the vagina can come in several forms, such as pills, creams, suppositories, and flexible rings.
Vaginal dilators are devices that look similar to a large tampon without the applicator. They are made from either silicone or hard plastic, with the latter being preferred because the firmer plastic tends to work better at stretching the vaginal muscles. The dilators come in multiple sizes within a single kit. Using dilators allows you to gently stretch your vagina a little at a time. When using dilators, you should use a water-based lubricant to make insertion easier and less likely to cause irritation. Although many people start with the smallest dilator, it will depend on your unique needs. You should start with the largest dilator that you can comfortably insert.
Moisturizers are distinctly different from lubricants. You may use water-based lubricants before sex or a pelvic exam to make the process less painful and minimize irritation. However, moisturizers are designed to provide moisture to your vagina longer. Moisturizers are specifically designed to attach to dry cells in the vagina and hydrate them. Every moisturizer is different but may provide moisture for approximately three days before more moisturizer needs to be added. Most moisturizers are compatible with condoms, so it is not necessary to use a different product before sex or be concerned your moisturizer will damage the condom.
Although vaginal atrophy can be a difficult condition to deal with, there are several approaches that can make things more comfortable. When hormonal treatments are not an option, using a combination of non-hormonal treatments might be the answer.