Vaginal dryness at menopause

Vaginal dryness is a problem that every woman faces sooner or later. It is necessary to know the cause of this problem for timely diagnosis of the 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 medications.

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Epidemiology

The epidemiology of the vaginal dryness problem is such that more than 65% of women have encountered this pathology at least once in their lives, but only 10% have sought treatment. More than 80% of cases among women of climacteric age are difficult to correct, while among women of reproductive age, 95% of cases are a transient condition. This must be taken into account not only for diagnostic purposes, but also for the purpose of predicting treatment results.

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Causes vaginal dryness

The vagina is not a separate female organ, but a 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 movement of sperm through the vagina. The vagina is a muscular organ that is lined with epithelium on the inside, and the wall contains glands that secrete a secretion. This secretion is needed not only to maintain a normal pH, but also for the normal movement of sperm to the site of fertilization. Therefore, in case of insufficiency of this secretion and the development of vaginal dryness, this can become a serious problem for a woman of reproductive age with the development of infertility.

The trophic function of vaginal epithelial cells is mainly due to normal blood circulation in the subcutaneous tissue vessels, which help nourish the skin and mucous membrane, since there are no vessels in the skin. At the same time, oxygen that enters the basal layer of the skin activates the respiratory chain and thus energy is synthesized, which is deposited in the form of ATP reserves. As is known, any process of cell division requires an energy reserve, 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 vaginal dryness, the processes of normal gland cell division are disrupted, which is characterized by primary changes in the vaginal secretion, and then the process of cell division of the vaginal epithelium is disrupted again. Therefore, to identify the cause of vaginal dryness, you need to know some features of pathogenesis.

Therefore, the causes of vaginal dryness primarily impair normal blood circulation in the subcutaneous tissue and the amount of energy that is formed under conditions of oxygen starvation is insufficient to ensure the normal process of cell division. Therefore, the cells that are formed have an imperfect 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.

When talking about possible causes of such pathology, age differences are observed. In women of climacteric age, the cause is age-related changes in the structure of the cells themselves and hormonal disorders. In young women, there are more causes, which can be associated with many factors. One of the groups of such causes is the use of medications for a long time or their use in violation of the rules of use. Very often, you can find routine use of antibiotics, both systemic and local. 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 pathogenic flora dies, but also beneficial bacteria in the vagina. This happens with long-term treatment with an antibiotic or with an inadequately selected dose, or with the wrong choice of antibiotic without concomitant use of probiotics in people at risk. All this can cause the development of thrush in a woman, and then soon, due to a violation of the secretion of the glands, severe dryness in the vagina occurs and the problems only intensify. Vaginal dryness after antibiotics is a very common problem in young women, which does not depend on the type of antibiotic, but is largely a side effect of the use of local remedies. Vaginal dryness after Terzhinan is quite common, which is due to its composition. This drug is used for the complex treatment of vaginitis, colpitis, vaginosis. The drug contains the antibiotic neomycin and ternidazole, as well as the antifungal agent nystatin and prednisolone. The drug has a very good therapeutic effect, but at the same time, vaginal dryness develops quite often due to the presence of a hormone and an antibiotic. Therefore, it is necessary to differentiate the choice of drug for treatment, especially in women who have previously encountered this problem.

The second most common cause of vaginal dryness is surgery. This is due to the fact that any surgery disrupts the normal structure of the mucous membrane of the genitals and the vagina in particular, which leads to a short-term disruption of the function of the vaginal glands and does not produce vaginal secretions. Cell division is also disrupted, which aggravates the symptoms. Such disorders are more common after an invasive abortion, when the mucous membrane is scraped out and time is needed to restore the normal function of the epithelium of the uterus and vagina. Removal of the uterus or ovaries can also be a cause. Vaginal dryness after removal of the uterus is explained by the fact that tissue trophism is disrupted due to poor blood circulation, and the uterine glands do not secrete the secretion necessary to prevent dryness. After a cesarean section, dryness develops for the same reason due to a short-term disruption of the normal structure of the uterine endothelium and glands.

Risk factors

Taking into account the reasons for the development of this pathology, it is necessary to highlight the main risk factors:

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

These risk factors must be taken into account not only to identify sick patients, but first and foremost, for the purpose of primary prevention of the development of vaginal dryness, especially in women of reproductive age.

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Symptoms vaginal dryness

The first signs of vaginal dryness can manifest acutely. In this case, there may be signs of burning in the vagina or itching, which are not accompanied by any discharge. Often, patients complain of urination problems in the form of itching and burning in the urethra, which is associated with irritation of the thin mucous membrane. This causes discomfort, which makes you see a doctor. But the first symptoms may not have any manifestations, which is dangerous in terms of the development of other complications.

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

In women of reproductive age, symptoms may appear during sexual intercourse. Vaginal dryness during and after sex is a common complaint due to the fact that the vaginal mucosa secretes less and becomes thinner, which contributes to microtraumatization and the occurrence of pain and burning during sexual intercourse. Such trauma may be accompanied by more serious changes and dryness and redness of the vagina or an unpleasant odor develops. Then we are talking about a possible infection with pathological flora, which requires more serious measures. Often this is also accompanied by discharge.

Vaginal dryness before or after menstruation only indicates a change in hormones and does not require special intervention if it does not cause any other symptoms.

Dry mouth and vaginal dryness combined with mild itching of the genitals in older women with excess body weight may be one of the first manifestations of diabetes, which should also be taken into account in such cases.

If you feel sick, your breasts hurt, and your vagina is dry, these may be the first signs of pregnancy, as hormones are being redistributed between the mother's body and the body of the future child. Therefore, with such a combination of symptoms, this option should not be ruled out.

Vaginal dryness during pregnancy is also a common pathology that requires a solution to prevent trauma to the birth canal. Often this occurs due to hormonal disorders, so this should be taken into account as well.

The consequences and complications of vaginal dryness are, first of all, the development of trauma and infectious processes. In this case, colpitis or vaginitis may develop secondarily. Also, ascending urinary tract infections - cystitis, urethritis, pyelonephritis - may be a complication. Pain and dysfunction of sexual intercourse are also serious consequences of this problem.

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

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Diagnostics vaginal dryness

Often women do not know what to associate their condition with and the problem of vaginal dryness is revealed only when it already causes significant problems. Therefore, it is necessary to be attentive to this issue and not to exclude any symptoms, taking into account possible etiological factors. Therefore, for correct diagnosis, it is necessary to carefully collect anamnesis. It is important to find out when such symptoms first appeared and whether it is associated with surgical interventions or the use of medications. It is necessary to find out what the nature of the symptoms is now, how the symptoms have changed depending on the situation, and also to detail the patient's complaints. Sometimes, already at the survey stage, it is possible to make a preliminary diagnosis and determine the treatment tactics.

Further, an important diagnostic point is the examination of the woman in the mirrors, which allows to identify disorders in the form of dryness of the vaginal mucosa, pathological discharge, which can confirm the diagnosis. The presence of dryness, cracks or microtraumas 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 occurs against the background of vaginal dryness and a decrease in its protective function. This is also important for the purpose of differential diagnostics.

The tests that are necessary to clarify the diagnosis are general clinical and special. General tests include blood tests, biochemical blood tests with lipidogram and kidney function indicators, and urine tests. As for special tests, a microbiological examination of a smear from the posterior vaginal fornix is mandatory. This smear makes it possible to determine the possible causative agent of the inflammatory process, which may be due to vaginal dryness, and the degree of vaginal cleanliness. This is important for the purpose of differential diagnosis of various disorders. It is also necessary to conduct a cytological examination of a smear from the cervical canal. It allows you to exclude metaplastic processes, which are often a complication of vaginal dryness. Thus, the tests help to conduct a more serious study and exclude other pathologies.

Instrumental diagnostics are 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 recurrent course of the disease. Colposcopy is used for this. This is a research method that involves using a special device - a colposcope. This allows you to see the vaginal mucosa in magnification of several dozen times. In this case, you can visualize those changes that are not visible during a normal examination. The advantage of this method is also the possibility of a parallel biopsy. It can be performed with special forceps, which are at the end of the colposcope. The mucosal material is sent for histological examination to identify the degree of changes and exclude malignant transformation.

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Differential diagnosis

Differential diagnostics of vaginal dryness should be carried out taking into account the main symptom and in order to exclude organic pathology, especially if it is a young woman, for whom it brings many problems, including problems with conceiving a child. Often the main symptom is unpleasant sensations in the form of burning and itching, then it is necessary to differentiate this from thrush, which is accompanied by the same subjective sensations and often occurs in young women. But the main diagnostic difference of thrush is the discharge, which is white, cheesy in nature, has an unpleasant odor, which can be immediately determined during examination. Such discharge can be very abundant or, conversely, scanty. With vaginal dryness, there should be no discharge, if this is only this pathology.

Also, vaginal dryness during menopause should be differentiated from erosion. Erosion is a defect of the mucous membrane, which has a characteristic appearance during colposcopy and is easy to distinguish from simple microtrauma with vaginal dryness. Erosion in girls under 25 years old can be physiological, so it is necessary to distinguish between these concepts in order not to harm with unnecessary treatment measures. It is also important to carry out differential diagnostics with vulvar kraurosis. This is a pathology that is characterized by the presence of dysplastic processes in cells with a tendency to atypical growth, and this is often a consequence of untimely treatment of vaginal dryness in women during menopause. Therefore, it is so important to conduct a histological examination of the smear for accurate differential diagnostics of these two processes.

Correct diagnosis and adequate differential diagnosis allow timely identification of any disorders to relieve symptoms and improve the patient’s quality of life.

Treatment vaginal dryness

Treatment of vaginal dryness should be comprehensive and should have an etiological focus. It is important to first eliminate the cause, and only then use treatment. There are drug and non-drug treatments. Drug treatments 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 at a preventive effect on the other. It is very important to regulate your lifestyle and diet, which directly affects our health. First of all, for the duration of treatment and until the symptoms disappear, you need to give up sexual activity, as this increases trauma and reduces the barrier function. It is necessary to use local remedies to correct the condition.

1. Ovestin is a hormonal agent, the active substance of which is estriol from the group of short gestagens, which allows it to be used as a pathogenetic agent. Estriol restores the normal function of endothelial cells and relieves general symptoms of the disease by stimulating the proliferative activity of cells. It is recommended to use this drug only against the background of a study of the patient's hormonal background. The method of administration of the drug is in tablets at the same time of day, preferably before meals. The dosage of the drug is one tablet per day throughout the entire time without breaks. Fluid retention and headaches are possible, so the drug is not recommended for concomitant hypertension. Jaundice and uterine bleeding are also possible, which requires dose adjustment. Contraindications to taking the drug are pathology of the blood coagulation system, pathology of the coronary vessels and veins, diabetes, a history of cerebral hemorrhage or ischemic stroke. Precautions – if antibiotics are used, the effectiveness of the drug is reduced, so it is necessary to dose the drugs correctly and take into account their interactions.
2. Angelique is a hormonal agent that contains estradiol in its composition and can be used to treat vaginal dryness in women during menopause. The mechanism of action also lies in the pathogenetic features of the action of estrogens on cells. In this case, the drug acts on hormonal imbalance and due to this, vaginal dryness during menopause is less pronounced. The drug has a beneficial effect due to its local action on the endometrium and glands, by increasing the secretion of secretion, which helps to normalize not only the dryness of the vaginal skin, but also restores the environment for the further normal functioning of lactic acid bacteria. Due to this effect, the secretion of vaginal mucus is restored. The dosage of the drug is one vaginal tablet once a day. Precautions - in the presence of kidney stones or gall bladder, the drug should be used with caution. Side effects may include allergic reactions, initial engorgement of the mammary glands, minor uterine discharge. It may also affect the central nervous system with the development of headaches and increased depression.

Lubricants for vaginal dryness are used to eliminate discomfort during intercourse, as well as in complex treatment for faster restoration of the normal condition of the vaginal mucosa. For this purpose, you can use gels, ointments, and oils with various vitamins.

3. Ginocomfort 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 damaged 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. How to use - draw gel into the applicator, insert into the vagina and remove the applicator. Side effects can only be 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, as it has a pronounced restorative effect on the mucous membranes.

The use of vaginal pH normalizing agents 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 vaginal dryness treatment is the use of local probiotic agents.

4. Ecofemin is a product that helps normalize vaginal microflora due to the content of specific lactobacilli, which have antagonistic properties in relation to pathogenic microorganisms. The main active ingredient of the drug is lactobacilli of different strains, which normally populate the vagina and help normalize the pH. The dosage of the drug is one vaginal tablet two times a day, the course of treatment is six days without breaks. Method of application of the drug - it is necessary to use suppositories 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 for this pathology due to its natural composition and rich properties. Calendula is a natural source of minerals and many microelements. Calendula flowers contain vitamins of different groups - A, C, D and various microelements. This plant contains active substances and polyunsaturated acids - which improves local metabolic processes in the cell and stimulates the metabolism of the whole body. Phytoncides are natural antibacterial substances that inhibit the reproduction of most bacteria. Flavonoids have a pronounced antioxidant property, which prevents the development of malignant processes in cells and tissues. Polyunsaturated fatty acids inhibit inflammatory processes in the cell due to the suppression of characteristic genes and enzyme systems. Due to its wide composition, this plant is widely used in medicine and mainly in gynecology due to its beneficial properties: desensitizing and restorative properties, bactericidal and fungistatic properties, tonic and local softening properties. The drug also has an antispasmodic property, which helps reduce local irritation and pain.

The drug is available in the pharmacological form of ointment. For treatment, you need to make a gauze swab and soak it in the ointment and insert it into the vagina twice a day - in the morning and in the evening. After the procedure, you need to rest for some time, which improves the effectiveness of such local treatment due to increased absorption. The course of treatment should be at least a week, and even better ten days for a 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 caution in case of hay fever.

This local treatment promotes regression of symptoms and normalizes the function of the glands with an improvement in the barrier function of the vagina.

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

Surgical treatment of this pathology is not used.

Traditional treatment for vaginal dryness

Folk remedies are preferred because they can be used for a long time without causing much harm to health, and sometimes they can completely eliminate symptoms.

1. A very good and convenient remedy for local use is washing with medicinal solutions. For this, you can use chamomile and succession. Five tablespoons of chamomile and two tablespoons of succession are poured with a liter of hot boiled water, and then infused for ten minutes. You need to wash with a warm solution twice a day.
2. Washing with a solution of orthilia secunda at night will help relieve itching and burning. To do this, first take the leaves of the plant, pour boiled hot water over them and leave until the solution becomes slightly warm. After that, add a few drops of ampoule vitamin A and E and perform evening hygiene procedures with this solution. The course of treatment is at least five days.
3. A good remedy for treating kraurosis is considered to be the use of sea buckthorn. To do this, take sea buckthorn oil, which can be purchased at the pharmacy in a jar, then make a gauze tampon, apply the oil to the tampon and insert it into the vagina for twenty minutes. This remedy has excellent moisturizing properties, which will relieve irritation and the symptoms will decrease.

Herbal treatments can be used as tea to restore normal function of the vaginal mucosa, as well as as topical agents.

1. To prepare a medicinal solution, a herbal tea is prepared, which has a hysterotropic effect. Yarrow and sage leaves are infused in boiled water and boiled for another five to ten minutes, after which they drink instead of tea up to four times a day.
2. 2 tablespoons of nettle leaves are brewed in boiled water and infused, after which half a glass is taken 2-3 times a day.
3. Plantain has affinity for vaginal tissue and helps reduce itching and dryness by improving blood circulation. Plantain infusion also has a calming effect. To prepare the medicine, take parsley leaves, pour alcohol over them and leave for at least three days. Take this solution one teaspoon in the morning and evening.

Homeopathic treatment has its advantages due to the possibility of long-term treatment and multifaceted effects on the woman's body.

1. Sepia Plus is a combined homeopathic remedy in liquid form. It is available in the form of drops and the dosage of the drug is eight drops per dose. Directions for use: drip the solution into 100 milliliters of boiled water and drink half an hour before meals. The course of treatment is at least three months. Precautions: use with caution in case of recent traumatic brain injury and cerebral vascular pathology. Side effects are rare, allergic skin reactions are possible.
2. Crocus is a homeopathic remedy that has a composition of organic agents and helps to normalize vaginal secretions and eliminates itching and burning, moisturizing the mucous membrane. The drug is used in the pharmacological form of homeopathic drops and is dosed four drops twice a day half an hour before meals at the same time. The course of treatment is three months. No side effects have been identified. Contraindications to taking Crocus are hypersensitivity to the components of the drug.

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Prevention

Prevention of vaginal dryness can be non-specific and specific. Non-specific preventive measures include timely treatment of inflammatory diseases of the female genital area, avoidance of prolonged and unjustified use of antibacterial agents, and normalization of sexual life. Specific measures can be used after surgical interventions - for this purpose, vaginal creams and ointments based on natural remedies and vitamins can be used.

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Forecast

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

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