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Atrophic vaginitis is already explained by synonyms such as: atrophic vaginosis or senile vaginitis. Interestingly, this group also includes infant vaginitis and vulvitis, as they are based on the same mechanisms.
Atrophic vaginitis – prevalence
Atrophic vaginosis is associated with a reduced production of sex hormones (especially estrogens), which is why women most often suffer from them around the menopause – but not only them. The second factor that occurs in young women is the artificial reduction or inhibition of estrogen secretion in the event of, for example, surgery and / or removal of the ovaries. It is also important that, unlike other peri-and postmenopausal symptoms, symptoms associated with atrophic vaginosis worsen over time, and their spontaneous resolution is unfortunately unlikely.
The causes of atrophic vaginitis
At the root of atrophic vaginosis is the deficiency of the sex hormones – estrogens, i.e. hypoestrogenism. Estrogens have a huge impact and ensure the proper functioning of the entire woman’s body and the reproductive system. The effects of estrogens include those that are directly related to the issue under discussion, i.e. changes taking place in the vaginal epithelium. By regulating the proper blood flow in the vascular plexuses, estrogens regulate the metabolism of the vaginal wall tissues and ensure its elasticity. Additionally, they control the secretion of vaginal fluid. Necessary to maintain the proper condition of the vagina is the physiological bacterial flora of the vagina, which includes, among others lactobacilli. These bacteria ensure adequate acidity of the vaginal environment by producing lactic acid, the substrate of which is glycogen.
Atrophic vaginosis – symptoms
The development of the above-mentioned changes leads to the appearance of ailments that form the clinical picture of atrophic vaginitis. Vaginal dryness is the main symptom in nearly 30% of women. Every fourth patient complains of irritation and itching of the vagina and the vulva area. Changes in the vaginal environment create good conditions for pathogenic microorganisms to develop and multiply, causing inflammation of the vagina. Over 10% report abnormal vaginal discharge. Also, every tenth woman experiences pain during sexual intercourse, which is called dyspareunia. Some of these women will develop bleeding or spotting after intercourse. However, it is extremely important that in the course of atrophic vaginitis there should be no spontaneous bleeding or spotting from the genital tract. In any such situation, you should visit a gynecologist who will order additional tests, often along with a referral for curettage of the uterine cavity. Only this test will rule out such a dangerous disease as endometrial cancer.
It should be emphasized once again that trophic changes and the symptoms resulting from them increase with age, although the degree of severity of the symptoms varies between women. New research has shown that the severity of vaginal symptoms is significantly associated with the coexistence of diabetes. In addition, it is interesting that women with low body weight suffer more from the symptoms of atrophic vaginitis than obese women who have greater peripheral production of estrogen in adipose tissue.
The vaginal dryness symptoms are relieved by globules such as Florakcid vaginal globules with hyaluronic acid.
Additional assessment of the changes taking place in the vagina
The complaints reported by patients are the basis for starting research in order to make the most accurate diagnosis. In order to objectify the assessment of the vaginal condition, a point scale has been introduced in medical practice. The following parameters are assessed on this scale: the pH value of the vaginal environment, vaginal discharge, its consistency and color. Next, the appearance of the mucosa epithelium and possible ecchymosis or bleeding are assessed. Vaginal moisture, folds of the wall and the color of the mucosa are also scored. The entire examination is carried out by a gynecologist during a gynecological examination in the specula. Additionally, it is possible to define the so-called the cytological index of cell maturation in the patient.
Atrophic vaginitis – treatment
The phenomenon of atrophic vaginitis is common and therefore many women experience significant discomfort, even stress, and in large part it leads to sexual dysfunction and a general reduction in their quality of life. The treatment is determined by the doctor because it depends on the etiology of the ailments and includes several equal possibilities. Anti-inflammatory treatment in the event of a diagnosed infection is particularly important because, if left untreated, it may lead to various complications.
Patients should pay attention to the material and quality of the underwear they wear and the type of intimate hygiene products used, and avoid substances that irritate the genitals. Strongly perfumed hygiene products should be replaced with mild soaps of a moderate composition adapted to the needs. Lifestyle modification often has a positive effect, which includes not only stopping smoking, which is so detrimental to estrogen metabolism, but also removing foods and spices that aggravate disease symptoms from the diet. The list includes, among others next to alcohol, chocolate, paprika and pepper. Sexual intercourse has been shown to be beneficial by increasing the blood flow to the pelvic organs. One should also not forget about comorbidities, of which atrophic vaginitis is of great importance, for example, diabetes. Proper glycemic control has a positive effect on the condition of the genital tract. There are numerous probiotics and preparations with a moisturizing effect and supporting the healing processes of the vaginal mucosa.
All of the above methods are often only supportive treatments, as most often the decisive factor is hormonal treatment with the use of estrogens systemically or locally. The choice of a specific form and drug is made by the patient together with the gynecologist, taking into account the individual needs of the woman.
Unfortunately, ailments of the genital tract are still a taboo subject, especially for elderly women. It is wrong to think that there is no help or treatment “in this age”. The most important thing is to seek help, which is why it is so important to talk openly with your doctor and articulate your problems and needs.
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