Vaginal Health as You Age

As women become older or reach menopause, changes in vaginal health can start to become bothersome. The changes are caused by a decline in women's natural estrogen levels and as a result women start experiencing changes associated with this decline. One of the most significant changes can be feeling vaginal dryness, referred to as vaginal atrophy and subsequent discomfort with sexual contact.  

Symptoms of vaginal dryness include feeling irritation when sitting and/or feeling dryness when sexually active. Spotting or bleeding can occur after intercourse when vaginal dryness exists, but this should always be checked with your doctor. In order to address this concern, women have the option of using vaginal lubricants and creams that may help with feelings of discomfort during intercourse.

Vaginal dryness can be addressed with natural over the counter lubricants, creams and lotions. Many physicians will also recommend vaginal estrogen therapy, which can help restore the vaginal pH by restoring levels of estrogen in the vaginal tissue. Patients with a history of breast cancer are counseled to speak to their doctors before starting any new therapies with vaginal estrogen. Other modalities that can be used include vaginal suppositories with DHEA, hyaluronic acid and/or lubricants. Data is still growing with the use of all these adjuncts to vaginal health. 

More recently, CO2 laser therapy with MonaLisa Touch can also help address changes with vaginal tissue health. MonaLisa Touch is a laser-based therapy that helps to stimulate new collagen growth with Co2 laser stimulation and women report feeling marked improvement in vaginal health. In fact, chronic vulvar pain and vaginal burning remains one of the most perplexing problems that gynecologist try to address with their patients, and research is now showing the effectiveness of MonaLisa Touch treatments! 

Every woman facing vaginal dryness and subsequent dyspareunia (painful intercourse) needs to speak further with their provider about all options available to them. The American College of Obstetrics and Gynecology (ACOG) recommends that healthcare providers discuss the benefits and risks of all available treatment options for vaginal symptoms, including over-the-counter lubricants, vaginal moisturizers, and FDA approved vaginal therapies such as vaginal estrogen and intravaginal dehydroepiandrosterone and oral therapies such as hormone therapy and ospemifene to determine the best treatment for women with vaginal atrophy and painful syndromes associated with dryness. 

Author

Aileen Caceres MD Aileen Caceres, MD, MPH, FACOG, is board certified in obstetrics and gynecology, and specializes in delivering comprehensive surgical care for all women. She is a fellowship-trained specialist in minimally-invasive and gynecologic robotic surgery, and has expertise in treating fibroids, abnormal bleeding, chronic pelvic pain, pelvic organ prolapse, urinary incontinence and pelvic masses. Dr. Caceres offers leading-edge surgical technology and in-office procedures to women of all ages.