“I’m in terrible pain when I pee. I have repeated vaginal infections and cystitis and I’m beginning to have frequent urine leakage. It’s all exhausting. Are there effective treatments to treat these problems?”
The gynaecologist’s answer :
Pain during sexual intercourse and urination, urine leakage, cystitis or recurrent vaginal infections, often accompanied by dryness and irritation of the vagina and vulva, make one immediately think of vaginal atrophy. Also known as atrophic vaginitis or urogenital atrophy (UGA), this uncomfortable condition, which very frequently occurs during the menopause – it is diagnosed in 25 to 50% of menopausal women – is primarily due to a decrease in the oestrogen level.
However, if is only four to five years after the menopause that physiological changes become clinically visible and women complain of repercussions on their sexuality and quality of life.
While the drop in oestrogen happens naturally and gradually during the menopause, it may also occur more suddenly under other circumstances. This is what happens when certain cancer protocols – ovary removal or anti-oestrogen drugs – artificially block oestrogen production.
To properly understand the cause-and-effect relationship between a drop in oestrogen and the occurrence of vaginal atrophy, it should be remembered that the vagina is a musculomembranous organ. And like any muscle, it needs energy to maintain its elasticity, thickness and solidity. This “nourishing” function is primarily fulfilled by a sugar – glycogen.
However, when the oestrogen level is low, glycogen production in the tissue of the vagina, vulva, bladder and urethra is considerably slowed down.
The cell layers thus appear thinner and more fragile. This tissue weakness can cause a series of problems to occur: fibrosis and a reduction in the vaginal cavity, which becomes shorter and narrower, scars on the vulva, small tears or microfissures at the vaginal opening, aggravation of a pre-existing problem of stress urinary incontinence. This urine leakage risks irritating the thinned vulvar tissue, contributing to the occurrence of itching, burning and unpleasant odours.
And that’s not all. Glycogen is also the favourite food of the “good bacteria” in the vaginal flora, lactobacilli, which turn it into lactic acid to stop infections and prevent pathogenic bacteria from developing. However, when glycogen diminishes, the lactobacilli can no longer fulfil their protective role and vaginal and urinary infections develop.
The good news is that these disadvantages can be easily prevented by adopting a new lifestyle routine. And if the condition has already taken hold, don’t panic! We can reverse the situation with aesthetic gynaecological protocols. Effective, safe, fast and non-invasive, they represent a remarkable alternative to hormone replacement therapies, which are often prescribed during the menopause but prohibited for any women who have had a hormone-dependent cancer (ovarian, uterine or breast cancer).”
Before suggesting a treatment, the doctor will confirm the diagnosis by taking a medical history, followed by a clinical and gynaecological exam. If the patient does not present any contraindications, such as an active urinary infection or a herpes flare-up, the appropriate SOS dryness protocol may immediately begin.
1st stage: Inflammatory symptoms prevail: swollen, red and painful vulva.
2nd stage: It is primarily characterised by a loss of volume (also described by the term atrophy), skin is less firm and has lost elasticity. The labia majora and minora are flattened.
3rd stage: it is characterised by both inflammatory symptoms and loss of volume or atrophy. Female genital organs that have become slack over time lead to both aesthetic and functional problems, including repeated infections, stress urinary incontinence and reduced sensation during sexual intercourse.
When we bear in mind that, given today’s life expectancy for women, vaginal atrophy problems may well be present for 1/3 of their life… it is worth addressing them as early as possible.
Adopting certain daily habits can significantly improve this condition and the associated symptoms:
– Do not ignore lasting pain or vaginal and urinary infections. The earlier the prevention and care, the greater the chance of pain and discomfort being relieved or even disappearing.
– Stop smoking or at the very least reduce cigarette consumption. Why? Because smoking causes a reduction in oestrogen secretion, which leads to an increased rate of vaginal atrophy and osteoporosis.
– Do specific exercises to retrain the pelvic floor. Stretching like a hammock between the pubis and coccyx, in women the pelvic floor is made up of a group of muscles surrounding the urethra, vagina and rectum. By activating the blood circulation and strengthening pelvic muscles that have become weak and slack due to hormone changes, certain postures help to reduce or even eliminate symptoms associated with vaginal atrophy.
In order to do each exercise properly, it is recommended to schedule several sessions with a physiotherapist with expertise in pelvic floor retraining. Then, at home, you adopt a regular rhythm and stick to it: three exercises twice a day, five days a week, for at least two months. The benefits appear after four to six weeks’ training. Urinary incontinence has disappeared, vaginal pain has eased, sexual intercourse becomes pleasant and a source of pleasure again.
– Consider probiotics to rebalance the vaginal flora, whose composition, which is lacking in “good” bacteria (lactobacilli), can no longer stop urinary and vaginal infections. However, you must choose your probiotics carefully depending on your condition.
– Drink pure cranberry juice (and not a drink based on cranberry). This beverage, packed with vitamin C and antioxidants, is renowned for reducing the risk of recurring urinary infections that often go hand in hand with vaginal atrophy.
*This general advice does not, under any circumstances, replace a medical opinion. Ask your doctor for advice.