Dryness in the vagina with menopause

Dryness in the vagina is a problem with which, sooner or later, every woman meets. Know about the cause of this problem is necessary for the timely diagnosis of pathology and the correct treatment tactics. There are cases when this pathology brings a lot of unpleasant sensations, which requires certain measures, sometimes you can do with home remedies, and sometimes you need to use medicines.

[1], [2], [3], [4], [5]

Epidemiology

The epidemiology of the problem of dryness in the vagina is such that more than 65% of women encountered this pathology at least once in their life, but only 10% applied for treatment. More than 80% of cases among women of menopausal age are poorly amenable to correction, while in women of reproductive age, 95% of cases are a transient state. This need to be taken into account not only for the diagnostic purpose, but also for the purpose of predicting the results of treatment.

[6], [7], [8], [9], [10], [11], [12], [13], [14], [15], [16], [17]

Causes of the dryness in the vagina

The vagina is not a separate female organ, but it is part of a complex system that performs many important functions in the female body. The most important function of the vagina is participation in the reproductive function due to the fact that the sperm move through the vagina. The vagina is a muscular organ that is lined with epithelium inside, and the wall contains glands that secrete a secret. This secret is needed not only to maintain the normal pH state, but also for the normal movement of spermatozoa to the fertilization site. Therefore, if this secret is insufficient and the vaginal dryness develops, this can be a serious problem for a woman of reproductive age with the development of infertility.

Trophy of the cells of the vaginal epithelium is mainly due to normal blood circulation in the vessels of the subcutaneous tissue, which contribute to the nutrition of the skin itself and the mucosa, because there are no vessels in the skin. In this case, oxygen that enters the basal ball of the skin activates the respiratory chain and so the energy is synthesized, which is deposited in the form of ATP stores. As is known, for any process of cell division it is necessary that there is a supply of energy, which ensures the divergence of cells during mitosis. This is how normal cell division and the formation of new skin cells and glands occur. In the case of dryness in the vagina, the processes of normal division of the gland cells are disrupted, which is characterized by primary changes in the vaginal secretion, and then the process of dividing the cells of the vaginal epithelium is broken again. Therefore, to identify the cause of dryness in the vagina, you need to know some features of pathogenesis.

Therefore, the causes of vaginal dryness in the first place, worsen the normal blood circulation in the subcutaneous tissue and the amount of energy that is formed in conditions of oxygen starvation is not enough to ensure a normal process of cell division. Therefore, the cells that form in this case have a non-subscale structure and the functioning of the glands is insufficient. All these changes at the level of cellular trophism disrupt the normal operation of the vaginal mucosa and its function.

Speaking about the possible causes of this pathology, there are age differences. In women of menopausal age, the cause is the age-related changes in the structure of the cells themselves and hormonal disorders. Women of young age have more reasons, which can be due to many factors. One of the groups of such reasons is the use of medications for a long time or use them with violation of the rules of use. Very often one can find routine use in antibiotics, both systemic and local action. The most pronounced side effect is when using local antibacterial agents in the form of suppositories or vaginal tablets. Under the influence of antibacterial drugs, not only the pathogenic flora perishes, but also the beneficial bacteria of the vagina. This happens with prolonged treatment with an antibiotic or with an inadequately selected dose, or with an incorrect choice of an antibiotic without concomitant reception of probiotics in people at risk. All this can cause the development of thrush in a woman, and then soon as a result of a violation of glandular secretion there is a pronounced dryness in the vagina and problems only increase. Dryness in the vagina after antibiotics is a very common problem in young women, which does not depend on the type of antibiotic, but rather is a side effect of the use of local remedies. Dryness in the vagina after Terzhinan occurs quite often, which is due to its composition. This drug is used for the complex treatment of vaginitis, colpitis, vaginosis. The drug includes antibiotic neomycin and ternidazole, as well as an antifungal drug nystatin and prednisolone. The drug has a very good therapeutic effect, but at the same time, dryness in the vagina develops quite often due to the presence of a hormone and an antibiotic. Therefore, it is necessary to differentiate the choice of the drug for treatment, especially in women who have previously met with this problem.

On the second place on the prevalence of causes of dryness in the vagina - surgical interventions. This is due to the fact that in any surgical intervention, the normal structure of the mucous genital organs and the vagina in particular is violated, which leads to a short-term disruption of the glands of the vagina and does not produce a vaginal secret. Cell division is also impaired, which aggravates the symptoms. Such violations are more likely after an invasive abortion, when there is a scraping of the mucosa and it takes time to restore the normal function of the epithelium of the uterus and the vagina. Also, the cause may be the removal of the uterus or ovaries. Dryness of the vagina after removal of the uterus is explained by the fact that trophic tissue is disrupted due to poor blood circulation, and the secret necessary to prevent dryness is not secreted by the uterine glands. After cesarean, dryness develops for the same reason because of short-term disruption of the normal structure of the uterine endothelium and glands.

[18]

Risk factors

Given these reasons for the development of this pathology, it is necessary to identify the main risk factors:

1. frequent vaginitis, colpitis or chronic adnexitis in history - this is a springboard for the action of other etiological factors;
2. irrational and improper use of antibiotics;
3. pathological course of pregnancy;
4. surgical interventions on the uterus;
5. women in menopause.

These risk factors should be taken into account not only for identifying patients, but primarily for the primary prevention of dryness in the vagina, especially in women of reproductive age.

[19], [20], [21], [22], [23], [24], [25], [26]

Symptoms of the dryness in the vagina

The first signs of dryness in the vagina can be acute. There may be signs of burning in the vagina or itching, which are not accompanied by any secretions. Often patients complain of a violation of urination in the form of sensation of itching and burning in the urethra, which is associated with irritation of the thin mucous membrane. This causes unpleasant feelings, which makes one turn to the doctor. But the first symptoms may not have any manifestations, which is dangerous in terms of the development of other complications.

Dryness in the vagina with menopause has its own peculiarities, because it occurs gradually. This is due to the fact that trophic changes do not occur immediately and the symptoms are not so pronounced. As a sharp hormonal decline disrupts the work of many endocrine glands and affects the metabolism, the symptoms can be observed from all sensitive organs and systems. The peculiarity is that the woman is disturbed by insomnia, fatigue, emotional lability, a feeling of fever in the face, dizziness and these complaints have priority, in comparison with complaints of vaginal dryness. Often such symptoms are combined with dryness around the vagina, as the trophic of all surrounding tissues is disrupted.

In women of reproductive age, symptoms can be manifested during sexual intercourse. Dryness in the vagina during sex and after sex is a common complaint because the mucous membrane of the vagina secretes less secretion and becomes thinner, which contributes to microtraumatism and the appearance of soreness and burning sensation during sexual intercourse. Such a trauma can be accompanied by more serious changes and develops dryness and redness of the vagina or an unpleasant smell. Then we are talking about a possible infection with pathological flora, which requires more serious measures. Often this is accompanied by excreta.

Dryness in the vagina before the monthly or after the monthly indicates only a drop in hormones and does not require special intervention, if not causing any other manifestations.

Dryness in the mouth and vagina, combined with a slight pruritus of the genital organs in older women with excessive body weight, can be one of the first manifestations of diabetes, which must also be taken into account in such cases.

If you feel sick, chest and dryness in the vagina, then this may be the first signs of pregnancy, as there is a redistribution of hormones between the mother's body and the body of the unborn child. Therefore, this combination of symptoms should not be excluded and this option.

Dryness of the vagina during pregnancy is also a frequent pathology, which requires a solution for the prevention of traumatism of the birth canal. Often this is due to hormonal disorders, so you need to take this into account.

The consequences and complications of dryness in the vagina are, first of all, the development of trauma and infectious processes. In this case, colpitis or vaginitis may develop again. Also a complication may be an upward urinary tract infection - cystitis, urethritis, pyelonephritis. Pain and violation of sexual intercourse is also a serious consequence of this problem.

Given the possible symptoms and complications, then if any such symptoms occur, it is better to consult the doctor to determine the need for treatment.

[27], [28], [29]

Diagnostics of the dryness in the vagina

Often women do not know what to associate their condition with and the problem of dryness in the vagina is revealed only when it brings already significant problems. Therefore, it is necessary to be attentive to this issue and not to exclude any symptoms, taking into account necessarily possible etiological factors. Therefore, for proper diagnosis, you need to carefully collect anamnesis. It is important to find out when these symptoms first appeared and whether it is associated with surgical interventions or the use of medication. It is necessary to find out what character of the symptoms is now, how the symptoms varied depending on the situation, and also to detail the patient's complaints. Sometimes already at the stage of the survey, you can put a preliminary diagnosis and determine the tactics of treatment.

Further important diagnostic moment is the examination of the woman in the mirrors. , which allows you to identify violations in the form of dryness of the mucous vagina, pathological discharge, than can be confirmed by the diagnosis. The presence of dryness, cracks or micro-injuries can be seen with the naked eye, which will allow to judge the degree of changes and the presence of other inflammatory diseases, which often happens against the background of vaginal dryness and a decrease in its protective function. This is also important for the purpose of differential diagnosis.

Analyzes that are necessary to clarify the diagnosis are general clinical and special. General - a blood test, a biochemical blood test with a lipidogram and indicators of kidney function, urine analysis. With regard to special tests, it is mandatory to microbiological examination of the smear from the posterior vaginal vault. This smear makes it possible to determine the possible causative agent of the inflammatory process, which can be against the background of dryness of the vagina, and the degree of purity of the vagina. This is important for the purpose of differential diagnosis of various disorders. It is also necessary to conduct a cytological examination of the smear from the cervical canal. It allows you to exclude metaplastic processes, which are often a complication of vaginal dryness. Thus, analyzes help to conduct more serious research and exclude other pathologies.

Instrumental diagnosis is necessary for a more accurate study of the problem, especially in the case of the development of this pathology in women of reproductive age with a recurring course of the disease. To do this, use colposcopy. This is a method of research, which consists in using a special device - the colposcope. This allows you to see the mucous membrane of the vagina in an increase of several dozen times. In this case, you can visualize those changes that are not visible during normal inspection. The advantage of this method is also the possibility of a parallel biopsy. It can be performed with special forceps, which are on the end of the colposcope. The mucosal material is sent for histological examination to detect the degree of changes and exclude malignant transformation.

[30], [31], [32], [33], [34], [35]

Differential diagnosis

Differential diagnosis of dryness in the vagina should be carried out taking into account the main symptom and with the goal of excluding organic pathology, especially if it is a young woman, which brings many problems, up to the problems with conception of the child. Often the main symptom is unpleasant sensations in the form of burning and itching, then it is necessary to differentiate it with thrush, which is accompanied by the same subjective sensations and often happens in young women. But the main diagnostic difference of thrush are discharge, which have white color, curdiness, unpleasant odor, which can be determined immediately during the examination. Such discharges can be very abundant or vice versa. When vaginal dryness, there should be no discharge if it is only a given pathology.

Also, the vaginal dryness in menopause should be differentiated with erosion. Erosion is a defect in the mucous membrane, which in colposcopy has a characteristic appearance and can easily be distinguished from simple microtraumatism when the vagina is dry. Erosion in girls under 25 years can be physiological, so it is necessary to distinguish these concepts, so as not to harm unnecessary medical measures. It is also important to conduct differential diagnostics with vulva vulgaris. This is a pathology that is characterized by the presence of dysplastic processes in cells with a tendency to atypical growth, and often this is a consequence of untimely treatment of vaginal dryness in women of the menopause period. Therefore, it is so important to conduct a histological examination of the smear for an accurate differential diagnosis of these two processes.

Correct diagnosis and adequate differential diagnosis allows you to identify in time any violations for the removal of symptoms and improve the quality of life of the patient.

Treatment of the dryness in the vagina

Treatment of dryness in the vagina should be complex and should have an etiological focus. It is important to first eliminate the cause, and only then use the funds for treatment. There are medicamentous and non-medicamentous methods of treatment. Medical methods of treatment are aimed at eliminating the patient's complaints and symptoms using local symptomatic treatment. Non-drug treatment is aimed at correcting hormonal imbalance on the one hand and on the preventive effect on the other hand. It is very important to regulate the way of life and nutrition, which directly affects our health. First of all, during the treatment and until the symptoms disappear, it is necessary to abandon the sexual life, as this increases the trauma and reduces the barrier function. It is necessary to use local means for correcting the condition.

1. Ovestin is a hormonal remedy, the active ingredient of which is estriol from the group of short gestagenes, which makes it possible to use it as a pathogenetic agent. Estriol restores the normal function of endothelial cells and removes common symptoms of the disease by stimulating the proliferative activity of cells. It is recommended to use this preparation only against the background of the hormonal background of the patient. The way of using the drug is in tablets at the same time of the day, preferably before meals. Dosage of the drug - one tablet a day for the entire time without interruption. Possible fluid retention and headaches, so the drug is not recommended with concomitant hypertension. It is also possible the appearance of jaundice and uterine bleeding, which requires dose adjustment. Contraindications to taking the drug is the pathology of the blood coagulation system, the pathology of the coronary vessels and veins, diabetes, a history of cerebral hemorrhage or ischemic stroke. Precautions - in the case of antibiotics, the effectiveness of the drug is reduced, so you need to properly dose the drugs and take into account their interaction. 
2.  Angelica is a hormonal drug that contains oestradiol in the ovary and can be used to treat dryness in the vagina in women during menopause. The mechanism of action also lies in the pathogenetic features of the action of estrogens on cells. The drug acts in this case for hormonal inconsistency and due to this the dryness of the vagina during menopause is less pronounced. Beneficial effect of the drug due to its local effect on the endometrium and gland, by increasing secretion secretion, which helps normalize not only the dryness of the skin of the vagina, but also renews the environment for the further normal functioning of lactic acid bacteria. Due to this effect, the secretion of vaginal mucus is restored. Dosage of the drug - one vaginal tablet once a day. Precautions - In the presence of stones in the kidneys or gallbladder should be used with caution. Side effects can be in the form of allergic reactions, as well as the initial engorgement of the mammary glands, secretions from the uterus in a small amount. It is also possible to act on the central nervous system with the development of headaches, increased depression.

Lubricants for dryness of the vagina are used to eliminate discomfort during intercourse, as well as in complex treatment for faster recovery of the normal state of the vaginal mucosa. To do this, you can use gels, ointments, as well as oils with different vitamins.

3. Gynocomfort is a gel that consists of many components - chamomile, tea tree oil, mallow, panthenol and lactic acid. Due to this composition, the drug eliminates the symptoms of itching and burning, restores the affected areas of cells, moisturizes and softens the mucous membrane, preventing its damage. The drug is used in the form of a vaginal gel with an applicator. The dosage of the drug is three milliliters once a day. The way of application is to collect the gel into the applicator, insert it into the vagina and remove the applicator. Side effects can be only in the form of local irritation or redness, since the drug does not have a systemic effect.

Solcoseryl gel can also be used for treatment as a local remedy, since it has a pronounced restoring effect on the mucous membranes.

Use of funds to normalize the pH of the vagina is necessary to restore the work of lactic acid bacteria, which contributes to a better effect of other agents. Therefore, one of the components of treating dryness in the vagina is the use of probiotic topical agents.

4. Ecofemin   is a remedy that helps normalize vaginal microflora due to the content of specific lactobacilli, which have antagonistic properties in relation to pathogenic microorganisms. The main active substance of the drug is the lactobacilli of different strains, which normally colonize the vagina and help normalize the pH state. Dosage of the drug - one vaginal tablet two per day, the course of treatment - six days without breaks. The way of using the drug - it is necessary to use the suppository vaginally, but only in the absence of an active inflammatory process. Side effects are possible only in the form of unpleasant sensations of burning or itching in the vagina.
5. Calendula ointment is a remedy that is widely used in such pathology due to its natural composition and rich properties. Calendula is a natural source of mineral substances and many microelements. Flowers of marigold have in their composition vitamins of different groups - A, C, D and different microelements. This plant contains active substances and polyunsaturated acids - which improves local metabolic processes in the cell and stimulates the metabolism of the whole organism. Phytoncides are natural antibacterial substances that inhibit the multiplication of most bacteria. Flavonoids have a pronounced antioxidant property than the development of malignant processes in cells and tissues is prevented. Polyunsaturated fatty acids inhibit inflammation in the cell due to the inhibition of characteristic genes and enzyme systems. Due to its wide composition this plant is widely used in medicine and mainly in gynecology because of its useful properties: desensitizing and restoring property, bactericidal and fungistatic property, tonic and local emollient property. Also, the drug has an antispasmodic property that helps reduce local irritation and soreness.

The drug is available in a pharmacological form of ointment. For treatment, you need to make a gauze swab and moisten it in the ointment to enter the vagina twice a day - in the morning and in the evening. After the procedure, you need some time to rest, which improves the effectiveness of such local treatment due to increased absorption. The course of treatment should be at least a week, and preferably even ten days for better therapeutic effect. Side effects of the drug may be in the form of hypersensitivity and skin rashes, and local symptoms - itching, irritation, burning. Precautions - use with hay fever with caution.

Such local treatment contributes to the regression of symptoms and normalizes the glands function with an improvement in the state of the barrier function of the vagina.

Vitamins and physiotherapy can be used to improve the effect of medications, the most significant regenerating agent is vitamin A and E. Physical activity with vaginal dryness can be used with increased attention to the work of the pelvic floor muscles, which improves blood circulation and lymph flow.

Operative treatment of this pathology is not used.

Alternative treatment of dryness in the vagina

Alternative agents are preferred because they can be used for a long time without much harm to health, and sometimes they can completely eliminate the symptoms.

1. A very good and convenient means for local use is washing with medicinal solutions. For this you can use chamomile and string. Five tablespoons of chamomile grass and two spoons of a turn pour a liter of hot boiled water, and then insist for ten minutes. Warm solution should be washed twice a day.
2. To remove an itch and burning sensation the washing out for the night by a solution from a boric uterus will help. To do this, you must first take the leaves of the plant, pour them with boiled hot water and insist before the solution becomes a little warm. After that, you need to add a few drops of ampoule vitamin A and E and spend the evening hygienic procedures with this solution. The course of treatment is not less than five days.
3. A good remedy for the treatment of kraurosis is the use of sea-buckthorn. To do this, take the sea buckthorn oil, which can be purchased at the pharmacy in a jar, then make a gauze swab, apply oil on a tampon and insert into the vagina for twenty minutes. Such a product has excellent moisturizing properties that will relieve irritation and symptomatology will decrease.

Herbal treatment can be used as a tea to restore the normal function of the mucous layer of the vagina, and also as a local remedy.

1. To prepare a medicinal solution, tea is prepared from herbs, which has a hysterotropic effect. The leaves of yarrow and sage are insisted in boiled water and boiled for five to ten minutes, after which they drink tea instead of tea up to four times a day.
2. The nettle leaves in the amount of 2 tablespoons are brewed in boiled water and insisted, after which they take half a glass 2-3 times a day.
3. Plantain has a tropism to the vaginal tissue and helps to reduce the expression of itching and dryness by improving blood circulation. Also, the infusion of plantain has a calming effect. To prepare the medicine you need to take the leaves of parsley, pour them with alcohol and insist for at least three days. Take this solution should be a teaspoon in the morning and evening.

Homeopathic treatment has its advantages because of the possibility of long-term treatment and multifaceted action on the woman's body.

1. Sepia - plus is a combined homeopathic remedy, in the form of a liquid. It is available in the form of drops and the dosage of the preparation is eight drops per treatment. Method of application - the solution should be dripped into 100 milliliters of boiled water and drunk half an hour before meals. The course of treatment is not less than three months. Precautions - with recent cerebral trauma and the pathology of the vessels of the brain, use with caution. Side effects are rare, allergic skin reactions are possible.
2. Crocus is a homeopathic remedy that has a composition of organic substances and helps normalize the vaginal secretion and eliminates itching and burning, moisturizing the mucous membrane. The drug is used in the pharmacological form of homeopathic drops and dosed four drops twice a day for half an hour before meals at the same time. The course of treatment is three months. There were no side effects. Contraindications to admission Crocus - is hypersensitivity to the components of the drug.

[36], [37], [38]

Prevention

Prevention of dryness in the vagina can be nonspecific and specific. Nonspecific preventive measures are timely treatment of inflammatory diseases of the female sexual sphere, avoidance of long and unreasonable intake of antibacterial agents, and normalization of the sexual life. Specific measures can be used after surgery - for this purpose, you can use vaginal creams and ointments based on natural remedies and vitamins.

[39], [40], [41]

Forecast

The prognosis of this pathology for recovery is favorable, especially in young women. In older women, hormonal drugs must also be used for effective treatment.

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