When Vaginal Atrophy Results in Dyspareunia

Dyspareunia, or pain during sexual intercourse, is one of the most common problems that has been frequently reported by postmenopausal women. According to various reports, dyspareunia pain has been observed to occur during or after the menopausal transition; this is mainly due to a decline in estrogen levels and vaginal atrophy. Typically, dyspareunia during menopause is persistent or recurrent pain with sexual activity. In most cases, the symptoms of dyspareunia in menopause can lead to marked distress or interpersonal conflict.

According to available data in the country, the symptoms of dyspareunia in menopause affects approximately 10-20% of women. Dyspareunia symptoms significantly impact a woman’s physical and mental health, body image, and relationship. here are some facts on vaginal atrophy and dyspareunia:

1. Symptoms of vaginal atrophy
In the initial stages of vaginal atrophy, physical examinations may be unhelpful. As the symptoms appear slowly, the vaginal mucosa becomes paler, thinner, less elastic, and drier. In the more advanced stages of vaginal atrophy, the mucosa may appear irritated and friable, and the vagina narrows and shortens. The symptoms of vaginal atrophy usually occur after menopause. It occurs when estrogen levels fall and the vaginal walls become dry, thin, and inflamed. The symptoms of vaginal atrophy are irritating and uncomfortable.

2. Diagnosis
The sexual history of the patient and a pelvic examination allows physicians to detect the symptoms of dyspareunia in menopause. Along with this, some of the other procedures used in the diagnosis of dyspareunia include provoked vulvodynia, inadequate lubrication, postpartum dyspareunia, and vaginal atrophy. According to studies, of the women who experience the symptoms of atrophic vaginitis post-menopause, only 20 to 25 percent seek medical help. Most of the patients do not consult a doctor, because they feel embarrassed due to the sensitive nature of this condition. The untreated condition of vaginal atrophy can lead to an inferior quality of life.

3. Common treatments
The treatment of dyspareunia is decided based on its underlying causes. The prime treatment procedures can include pelvic floor physical therapy, lubricants, surgical intervention, etc.

4. Estrogen’s role
Women with vaginal atrophy are at a higher risk of developing the symptoms of dyspareunia. According to various studies, vaginal atrophy approximately affects around 50% of postmenopausal women. This is primarily due to the decreasing levels of estrogen. It has been observed that most patients with the symptoms of vaginal atrophy do not consult their doctor because of embarrassment or assume that the symptoms are occurring due to age.

5. Prevention of vaginal atrophy
Immediate use of vaginal estrogen helps to prevent the symptoms of vaginal atrophy from becoming severe. This way you can protect the vagina. Regular sexual intercourse also helps in the prevention of developing the symptoms of vaginal atrophy. You can also opt to use water-soluble vaginal lubricants during sexual intercourse. This can be especially useful in mild cases of this condition.