What is vaginitis and why is it related to menopause?

You mayhave heard about Vaginitis. This condition, also known as vulvovaginitis, consists of the inflammation of the vagina. Its symptoms are bothersome. The most likely ones are pain, itching and vaginal flow mutations (MedlinePlus, 2020). Menopause and perimenopause are two of the most common periods in which this condition may appear. In those specific stages, this medical condition is called atrophic vaginitis, atrophic vulvovaginitis or genito-urinary menopause syndrome, and it may appear quite seldom (Sanitas, 2021). While many women, almost 50% of them, may experience the condition after the menopause , only 15% of them suffer it before this period. (Flores, 2020): Today we will help you understand everything about vaginitis: the causes, the symptoms to look out for, risk factors and more. Get yourself comfortable and keep reading to find out all about it!

Why does vaginitis appear in menopause?

Before getting to know how it relates to menopause, we need to know what happens to the female body during this time. Among many other changes, there is a dramatic reduction in the production of hormones, such as estrogen. As a consequence of that loss, cells in the vagina change and the vagina walls become thinner and also weaker. Mucus production changes its pH (acidity) and also reduces in amount. So the vaginal flora mutates. At this time, the vagina gets dryer (Gandhi, 2016).

Signs and symptoms of the atrophic vaginitis

Atrophic vulvovaginitis does not cause any symptoms for most menopausal women. Therefore it is usually diagnosed within a routine gynecological check. For women who do develop symptoms (Mayo Clinic Staff, 2021), they often notice these during sexual intercourse: vaginal dryness, which may result in painful coitus, skin soreness; slight vaginal bleeding afterwards, genital itching or irritated labia. In addition, there can be problems urinating such as an aching feeling or urinating more frequently. Finally, there can be a change in the flow or urine such as more or less watery, thick or yellowish (Barad, 2021). If you visit your doctor, they will assess for wanatomy and morphological changes that cannot be observed from outside the body.. Those changes may include changes in the aspect of the vagina (pale, bright, dry or smooth walls), pubic hair (the quantity may diminish), rounded and small stains, the narrowness of the vaginal opening, pH disorder and loss of vaginal flexibility (Lev-Sagieof, 2015). What is vaginitis and why is it related to menopause?

Risk Factors

Menopause by itself is not a risky situation, but atrophic vaginitis is a complication linked to it. The intensity of its symptoms may be stronger if they are related to any of the following risk factors (Mayo Clinic Staff, 2021):
  • Smoking: Being a regular smoker may cause the reduction of the amount of blood that gets to the vagina, resulting in weaker vaginal walls. In addition, it may reduce the function that estrogen has in the body.
  • Low sexual activity: Sexual intercourse supports vaginal elasticity and lubrication.

Alarm signs. When should you ask your doctor?

Although vaginitis symptoms are mostly only annoying, it is strongly recommended to ask your doctor as soon as possible if any of these disorders appear (Sobel, 2021):
  • Any kind of mutation in your vaginal flow, as it may be an infection.
  • Painful sexual intercourse that does not improve with lubricant gels.
  • Persistent itching and burning sensation.
  • Pain and Discomfort whilst urinating.
  • The appearance of crusts, bumps or injury in the vaginal lips.
  • Ulcers or other injures may suggest sexually transmitted infection.

Complications

Vaginitis can lead to additional complications if not treated: (Sobel, 2021):
  • Vaginal infections: predisposed by acidity and vaginal wall changes.
  • Problems urinating: can be linked to a urinary tract infection.

Can we prevent vaginitis in menopause?

The good news is that vaginitis in menopause can be treated and even prevented. To treat it, one of the options is the useof creams with estrogen (Lee, 2018). However, by taking some simple measures you can avoid symptoms or complications (Freeborn, 2019). Lets see some of them
  • Proper Hygiene: Use a neutral soap to wash your vulva in your daily bath (preferably made of glycerine or with aloe vera or chamomile) to keep your pH level balanced. Try to avoid vaginal douches and any kind of chemicals which are contained in commercial vaginal sprays.. Whenever you take a bath, be sure to wipe backward and not forward,, to avoid contamination .
  • Have an active life: Try to do different type of aerobic exercises like walking or cycling.
  • Dressing: Try to avoid wearing tight trousers. Choose comfortable cotton-made underwear and try to be careful with wet or humid clothes.
  • Respect your sleep: having adequate sleep will enable your body to rest and strengthen your immune system.
Now that you know everything about vaginitis in menopause: its causes, its, symptoms, its alarm signs, its possible complications and how to prevent it, you can keep on enjoying and learning everything about this new stage of your life, which should be one of your best periods. Menopause can be lived freely and does not mean suffering at all. Referencias bibliográficas Aslan, E., & Bechelaghem, N. (2018). To 'douche' or not to 'douche': hygiene habits may have detrimental effects on vaginal microbiota. Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology, 38(5), 678–681. https://doi.org/10.1080/01443615.2017.1395398 Barad, D. H. (2021). Prurito y secreción vaginal - ginecología y obstetricia. Manual MSD versión para profesionales. https://www.msdmanuals.com/es/professional/ginecolog%C3%ADa-y-obstetricia/s%C3%ADntomas-de-los-trastornos-ginecol%C3%B3gicos/prurito-y-secreci%C3%B3n-vaginal Flores, S. A., & Hall, C. A. (2020). Atrophic Vaginitis. En StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK564341/ Freeborn, D., Trevino, H., & Burd, I. (2019). Cómo prevenir la vaginitis. University of California. https://myhealth.ucsd.edu/Spanish/RelatedItems/3,82896 Gandhi, J., Chen, A., Dagur, G., Suh, Y., Smith, N., Cali, B., & Khan, S. A. (2016). Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. American journal of obstetrics and gynecology, 215(6), 704–711. https://doi.org/10.1016/j.ajog.2016.07.045 Lee, A., Kim, T. H., Lee, H. H., Kim, Y. S., Enkhbold, T., Lee, B., Park, Y. J., & Song, K. (2018). Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials. Journal of menopausal medicine, 24(1), 1–10. https://doi.org/10.6118/jmm.2018.24.1.1 Lev-Sagie, A. (2015). Vulvar and Vaginal Atrophy. Clinical Obstetrics and Gynecology, 58(3), 476–491. doi:10.1097/grf.0000000000000126 Mayo Clinic Staff. (2021). Vaginal Atrophy. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288 MedlinePlus. (2021). Vaginitis | vulvovaginitis. MedlinePlus. https://medlineplus.gov/vaginitis.html Sanitas. (2021). ¿Qué es la vulvovaginitis? Sanitas.es. https://www.sanitas.es/sanitas/seguros/es/particulares/biblioteca-de-salud/ginecologia/aparato-genital-femenino/vulvovaginitis.html Sobel, J. (2021). Approach to females with symptoms of vaginitis. UpToDate. https://www.uptodate.com/contents/approach-to-females-with-symptoms-of-vaginitis#H3657628475

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