Menopause and vaginal atrophy

 

 

A follow up to the last article regarding an early symptom of Menopause – vaginal dryness by Dr Steven R. Goldstein, a top doctor for menopause in NYC. In this article we’ll address vaginal atrophy. When a woman’s ovaries cease producing estrogen, she enters menopause. Without any estrogen in menopause the vagina becomes atrophic (the tissue wastes away). It loses blood supply and elasticity. It also loses its normal pH (acid/base balance) because it cannot support the normal predominant bacteria called lactobacillus that feasts on glycogen and produces lactic acid, thus lowering the pH.

Estrogen stimulates the creation of the vagina’s tough, outer layer of cells, known as the epithelium, that protects the delicate tissues underneath. It also moistens the vaginal mucus membranes, which increases lubrication.

Dr Steven R. Goldstein is a Menopause Specialist in NYC who has helped thousands of women over his 25+ years in private practice and overcome the symptoms of Menopause and lead a better quality of life, including a normal sex life.

Recent studies have shown that as many as 50% of postmenopausal women are not aware that there are treatments that are safe to treat this atrophy. They believe this is just a function of, “getting older.” Thus, many women “suffer in silence” and, if still partnered, are experiencing painful intercourse.

However, there are several helps for vaginal atrophy. First, there are very low dose estrogen creams, also tablets and rings. There is also now one oral non-estrogen, which may have other beneficial effects in breast and bone, as well. A local vaginal insert, which is DHEA (dehydroepiandrosterone) is also helpful. It is non-hormonal but is, however, metabolized to estrogen and testosterone.

Dr Goldstein, a top HRT Specialist in NYC, tells of a  55 year old patient who was recently remarried said “I thought dry would mean what it used to mean when you weren’t turned on with a man and you had to work a little harder at it. No one told me how dry you actually get and how difficult sex really becomes. For me, it just keeps getting worse. Astroglide helped, but my sister told me that in another year, even that isn’t going to do me much good. I’m getting one bladder infection after another”.

In the case of this patient, without estrogen replacement, the tissues will continue to get dry and can easily be injured during sex. Estrogen replacement is necessary to increase blood flow to the vagina and enhance sexual arousal, or to become lubricated enough to have comfortable sex.

Menopausal women who are sexually active will benefit greatly from hormone replacement therapy and avoid vaginal atrophy. Dr Steven R. Goldstein, a past President of the International Menopause Society and a Certified Menopause Practitioner with the North American Menopause Society and a leading hormone specialist in NYC is available for consultation at his New York City office.