Vaginal complaints: Vaginal atrophy and vaginal dryness

The list of vaginal complaints is long and their occurrence is frequent. In this blog post, we would like to briefly explain a typical complaint, vaginal atrophy and its consequences.

What is vaginal atrophy (vaginal dystrophy)?

Vaginal atrophy is the regression of the vaginal wall to a thin and smooth surface with limited functionality.

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What are the causes of vaginal atrophy?

The cause is usually the natural drop in oestrogen after the last menstrual period (menopause), which leads to vulvovaginal atrophy with typical symptoms such as vaginal dryness and pain during sexual intercourse (dyspareunia) in all women after the menopause. Oestrogens are largely produced in the ovaries and are important for maintaining blood flow, moisture (fluidity) and the elasticity of the tissue in the vagina.

Did you know?

Because the symptoms are caused by the natural decline in hormone levels during the menopause, every woman in this phase of life is potentially affected.
With the drop in oestrogen levels in the postmenopause, the vaginal epithelium flattens out and there is a lack of glycogen on the vaginal surface, which serves as a breeding ground for lactobacilli, which play a key role in healthy vaginal flora. The fluidity of the vagina decreases and vaginal dryness occurs.
Vaginal dryness is characterised by burning, itching and pain during sexual intercourse. It is a risk factor for infectious diseases and can also cause urinary tract problems.

In addition to vaginal atrophy, other causes of vaginal dryness include medication, breastfeeding and surgical and therapeutic interventions. Smoking and excessive intimate hygiene can also lead to vaginal dryness.

Another large group of women who may experience vulvovaginal atrophy are patients being treated for breast cancer. Therapy procedures such as radiotherapy are often accompanied by vaginal dryness.

How do I recognise vaginal dryness?

The diagnosis is made by the gynaecologist. Other diseases that cause similar symptoms must be ruled out. These include fungal infections and various sexually transmitted diseases, e.g. a genital chlamydia infection or trichomoniasis.

Depending on the trigger, hormones, moisturisers and agents to strengthen the vaginal environment are used for treatment.

What are the consequences of vaginal atrophy?

The pH value of the vagina changes to the less acidic range of 6.0 - 8.0. There is a change within the vaginal flora towards more coliform bacteria. Together with other atrophic changes, the altered pH value in combination with a reduced ability to regenerate is responsible for an increased susceptibility and frequency of infections and injuries. In addition, there is also pain and bleeding during sexual intercourse (dyspareunia).

What are the symptoms of vaginal atrophy?

Does atrophy also occur in young women?

In addition to postmenopausal women, around a quarter of young women using oral contraceptives (the pill) are also affected by atrophy in the vaginal area. In these women, a local oestrogen deficit is caused by inhibition of endogenous oestrogen production.


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