ATROPHIC VAGINITIS (vaginal dryness)

Vaginal dryness, vaginal thinning, and what is called “atrophy” are very common problems for menopausal women. Estrogens are responsible for the thickened, elastic, lubricated tissue of the vagina and vulva. When estrogen levels decline, the vulva loses its collagen, fat, and water-retaining ability. As a result, it becomes flattened, thin, and dry and loses tone. With estrogen loss, the vagina also shortens and narrows, and the vaginal walls become thinner, less elastic, and pale in color. Problems of vaginal dryness, vaginal discharge, and pain with vaginal sex are reported by two out of three women at the age of 75. The change that is usually noticed first is a feeling of dryness of the vagina. The cause is atrophy of the mucus-producing glands of the vaginal wall. With a loss in lubrication and a thinning of the tissue, the vagina is more prone to infections and mechanical injury from vaginal penetration. Small pinpoint bleeding, itching, and burning can result. Other tissue in the same area also becomes thin and atrophied. The urethral tissue, the labia, and the vaginal wall can all atrophy. These changes can progress to increased bladder infections and involuntary loss of urine.