Urogenital or Vulvovaginal Atrophy
Find out more about the urogenital or vulvovaginal atrophy, its symptoms and treatment
What is urogenital and vulvovaginal atrophy?
Urogenital atrophy includes atrophy of the vulva, vagina and the urinary tract, and occurs when the body produces less oestrogen, the hormone that helps keep these tissues healthy. The vulva and vaginal walls become thin, dry, and less elastic, causing itching and burning as well as discomfort during intercourse. Vaginal atrophy can also make women more prone to vaginal and urinary tract infections.
Atrophy of the urinary tract can lead to symptoms such as frequency of micturition, urgency and nocturia.
This condition is mostly associated with the menopause, but it can also happen after childbirth, during breastfeeding, or following cancer treatments when oestrogen levels are reduced.
It is important that a doctor assesses your symptoms and examines you to differentiate between vulvovaginal atrophy and other common conditions such as lichen sclerosus and lichen planus, which are treated differently.
What are the symptoms?
The symptoms of vaginal atrophy can vary from woman to woman but often include the following:
- Vaginal dryness
- Burning
- Itching
- Discomfort during sex
- Light bleeding after sex
- Increased frequency of micturition
- Nocturia – waking up at more frequently to pass urine
- Urinary incontinence
- Recurrent urinary tract infections
How can it be treated?
There are several ways to manage the symptoms of vaginal atrophy, including:
Vaginal Moisturisers & Lubricants: These can help alleviate dryness and make intercourse more comfortable. Our clinicians can recommend a variety of approved products that can be bought over the counter and can offer relief during intercourse but also for women who are not sexually active and need to reduce the daily discomfort associated with this condition.
Low-Dose Vaginal Oestrogen Therapy: This involves using a cream, tablet, or ring that delivers oestrogen directly to the vaginal tissues. This can help to restore moisture and elasticity to the vaginal walls. The treatments are very effective as the medication is delivered directly to the vaginal tissue with little if any absorption systemically. For this reason, low dose vaginal oestrogen can sometimes be used in high-risk groups such as women with a history of previous breast cancer. Vaginal oestrogen can also help with the urinary symptoms too.
Book your appointment
Book your appointment with our specialist team
Dr Neale Watson
Consultant Gynaecologist
Dr Mike Savvas
Consultant Gynaecologist
Dr Marilena Nicou
GP Menopause specialist
Frequently Asked Questions
What can I try at home to help with my Vaginal Atrophy?
We would recommend simple lifestyle changes such as drinking plenty of water, quitting smoking, and avoiding irritants like perfumed soaps and douches can all help to improve vaginal health.
Can I use Vaginal Oestrogen alongside HRT?
Yes, we often recommend that both are used simultaneously, especially in those with severe symptoms. In most cases, systemic HRT would help restore some of the vaginal architecture and improve dryness. This is often seen with dose adjustment of the transdermal HRT. There is no contra-indication in using the vaginal products alongside traditional HRT regimes, as the absorption is not equivalent and there is no accumulative effect when both are used together. This is very reassuring. This is evident by the fact that Progesterone is not required when using vaginal oestrogen alone.
What to Expect From Your Visit
The first visit will entail a comprehensive consultation, examination and hormone profile testing if required. Our highly qualified menopause specialists will guide you through the process of choosing the safest and most effective treatment to manage your symptoms.
A prescription will usually be issued, at the first visit if appropriate and a follow-up is arranged after 2-3 months to assess the effectiveness of the treatment and make changes as required. Our clinic allows for remote consultation for those who cannot make an in-person follow-up. This may be via a video or telephone call.
Additional services such as pelvic ultrasound scan, coil fittings, smear tests and bone density scan (DEXA) may also be performed as appropriate. We can also arrange for you to have a mammogram if you need one.