At Intimate You we are aware that vulvovaginal atrophy (VVA) is a common and underreported condition which is suffered by close to 50% of postmenopausal women. It is associated with decreased supply of oestrogen to the vulvovaginal tissue.
Sufferers may experience:-
- Initially, lack of lubrication during sex.
- Eventually, persistent vaginal dryness.
- Itchiness, soreness, and a stinging pain in the vaginal and vulvar area which, in turn, may further contribute to pain during sex.
- Vaginal spotting of blood, due to small tears in the vaginal skin surface.
- Thin yellow or grey watery discharge.
- Urgency, frequency, getting up during the night to pass urine, and urge incontinence.
- Recurrent urine infections.
Even while taking HRT prescribed by the GP or gynaecologist in the form of tablets or patches, 10% to 20% of women may still have some VVA symptoms.
Breast cancer treatment increases the prevalence of VVA because the surgery, endocrine effects, and chemotherapy drugs used in its treatment can cause or exacerbate VVA. Local oestrogen treatment for survivors of breast cancer remains controversial so symptoms may be very difficult to control.
So what can women do about VVA?
First-line VVA treatments available are:-
- Vaginal moisturisers – water based. These need to be applied regularly and are available to buy over the counter at a pharmacy.
- Vaginal lubricants – water or silicone based. Lubricants can also be easily purchased over the counter at a pharmacy and are used during intercourse. They may need to be re-applied several times during sexual activity and silicone based products may lead to loss of erection in a male partner.
- Low dose vaginal oestrogen – cream or pessaries to be inserted into the vagina, usually nightly initially then twice weekly ongoing. This is prescribed usually by a GP or gynaecologist
- Systemic oestrogen therapy – HRT tablets or patches. 10-20% of sufferers of VVA may still have some symptoms on HRT. Additional vaginal oestrogen may be used. These preparations are prescribed usually by a GP or gynaecologist.
For a significant proportion of women suffering from VVA the above treatments alone or in combination do not give relief from their symptoms and/or the treatments are not felt to be acceptable.