Post-menopausal struggles aren’t a common topic of conversation, but perhaps they should be. After all, women make up over half the world’s population. There are lots of people experiencing vulvovaginal atrophy out there who are likely suffering in silence.

Vuvlovaginal atrophy occurs when the tissues that make up the vagina aren’t working in a normal, healthy way because they are beginning to shrink, lose elasticity, and thin out. But help is out there. Here’s what you need to know about the condition.

1. It’s underreported

Though many postmenopausal women experience vulvovaginal atrophy and it can lead to a decrease in quality of life, it’s significantly underreported due to a lack of education around the condition.

“Many women don’t talk to their doctor about the symptoms … because they think it is a normal part of aging and menopause and just something they have to deal with.”
–Anuja Vyas, M.D.

“Many women don’t talk to their doctor about the symptoms of vulvovaginal atrophy — dryness, itching, painful intercourse, or frequent urinary tract infections — because they think it is a normal part of aging and menopause and just something they have to deal with,” Houston Methodist OB-GYN Anuja Vyas, M.D. tells Considerable in an interview.

However, Vyas reminds that any symptom that affects your quality of life or causes you stress is important enough to bring up with your doctor. 

2. It’s common — especially in postmenopausal women

While vulvovaginal atrophy can occur at any point in a woman’s life cycle, it’s most prevalent for women who are experiencing hypoestrogenism (or increased estrogen), which typically occurs in the postmenopausal phase.

“Vulvovaginal atrophy is extremely common,” Vyas confirms. “Between 60 to 70% of women who are menopausal will experience some symptoms.”

Though these symptoms can be intimidating and painful, diagnosis is simple — a combination of evaluating symptoms and a clinical exam. This is why advocating for yourself in the exam room is so imperative.

3. There are a range of treatment options

Fortunately, vulvovaginal atrophy isn’t permanent and there are a range of treatment options to take into consideration. “For most cases, we’ll start with over-the-counter lubricants and moisturizers to address the dryness, itching and painful intercourse,” Vyas tells Considerable. “If those don’t bring enough relief, other treatment options include oral and topical hormone therapies.”

If your doctor diagnoses you with vulvovaginal atrophy but the symptoms don’t bother you, then you may not necessarily need treatment.

Newer options include radio frequency thermal energy and laser therapies. Vyas explains that radio frequency heats the superficial (top) layers of the vulva and vaginal lining, while laser therapy burns off these surface layers. “These forms of therapy allow for healthier and more youthful cells and tissues to regenerate,” says the OB-GYN. “The newer cells will help increase vaginal lubrication and will have more collagen increasing tissue flexibility.”

However, Vyas notes that if your doctor does diagnose you with vulvovaginal atrophy, but the symptoms don’t bother you, then you may not necessarily need treatment. Many women who do have vulvovaginal atrophy or very mild symptoms may not need or want treatment, and that’s fine. Just have that conversation with your doctor about what is best for you.

4. Regular sexual activity can serve as a preventative measure

According to Harvard Health, regular sexual activity can be a way to prevent symptoms of vulvovaginal atrophy from surfacing. This is because sexual intercourse helps maintain vaginal tissue by improving blood circulation to the vagina.

Other than engaging in more sex, however, vulvovaginal atrophy generally can’t be prevented. But rest assured — it’s very easily treated. “It is so important for every women entering or in menopause to see their doctor regularly and be open and honest about their symptoms,” urges Vyas. “There is no reason for vulvovaginal atrophy to affect a woman’s quality of life, so it’s important for her to talk to her doctor so that they can help.”

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