Vulvovaginal Atrophy

In a new study, published in March of 2019, researchers have concluded that treatment of vulvovaginal atrophy (VVA) in postmenopausal women should start sooner than later.

Common symptoms of VVA include vaginal dryness, vaginal pain inside, pain during intercourse and exercise, bleeding during intercourse or sexual contact or bothersome burning, itching, or irritation. Some women experience leaking of urine during this time (urinary incontinence) which can also be a symptom of vulvovaginal atrophy. All too often, these symptoms go left untreated either because women are not aware that treatment is available, or they may not realize the impact the symptoms can have long term. The loss of estrogen associated with menopause affects the vaginal tissue. Eventually, the tissue becomes dry and pale. Over time, the labia may become fused, and the vaginal opening can narrow. Intercourse or other forms of vaginal contact can become painful and distressing.  An essential part of the annual well-woman exam is for her gynecologist to inquire about sexual health and these symptoms in perimenopausal and postmenopausal women. It is equally important for women to report these symptoms early to avoid distressing long term effects. By delaying treatment, the changes become less reversible and possibly irreversible, regardless of therapy.

This recent study noted a significant reduction in these long term impacts in women treated with traditional systemic estrogen therapy for hot flashes and night sweats. These symptoms, more commonly associated with menopause can begin well before the vaginal atrophy findings are noted. It is this early exposure to estrogen treatment which is thought to reduce the long term changes of vulvovaginal atrophy.

While a woman bothered by hot flashes and night sweats, along with vulvovaginal atrophy can find relief of all of her symptoms with systemic estrogen therapy, if VVA is her only concern, then local topical vaginal estrogen may be a better option. Not all women are candidates for estrogen therapy. MonaLisa Touch vaginal laser therapy is another option for treating VVA.  MonaLisa Touchis ideal for menopausal patients, post-menopausal patients, and breast cancer survivors who are often unable to receive conventional treatments for these debilitating symptoms.  A conversation with your gynecologist can help determine if you are a candidate and if you may benefit from treatment.

The takeaway is that the vaginal symptoms of menopause are common, can have long-lasting consequences if left untreated, and should not be viewed as a taboo topic. Treatment of vulvovaginal atrophy should be initiated at its early stages to prevent irreversible changes.


Dr. Kaleb Jacobs