Low oestrogen can occur due to natural menopause, cancer treatments, and other ovarian conditions.
Your ovaries produce oestrogen, so if the ovaries stop working or are removed, the result is very low or no natural oestrogen production. Your vaginal, vulvar, cervical, uterine, and urinary tissue is heavily dependent on oestrogen for its function, so when you take oestrogen away, you can end up with atrophic vaginitis (or if due to natural menopause, genitourinary syndrome of menopause or GSM). Atrophic vaginitis can have a devastating impact on women.
What is atrophic vaginitis?
Atrophic vaginitis is a condition whereby the vaginal and vulvar tissue becomes dry, irritated, and often itchy. It can tear and bleed very easily, even while wiping after going to the toilet, making life very uncomfortable.
Atrophic vaginitis also really puts a damper on sex, which becomes painful and essentially impossible. Atrophic vaginitis can contribute to urinary stress incontinence (sneezing, coughing or heavy lifting causing leakage of urine), since the tissue surrounding these organs and structures is slowly losing its form.
What you can see?
The classic signs of atrophic vaginitis are the inner labia (labia minora) receding, while the outer labia may show signs of atrophy. (Atrophy means to degrade or waste away, and while that may sound dramatic, it can just look like the tissue shrinks and loses its typical colour, appearance, and eventually, function.)
The inside of the vaginal lips and entrance to the vagina may be pale, shiny, and dry, and if there is inflammation, it may look red or pale with red spots.
Inside the vagina, the rugae – the muscular folds that characterise the feeling of the deeper vagina – start to even out and become flatter. The cervix – which you usually can’t see yourself – may become flush with the vaginal wall. The vagina may become shorter and narrower.
Discharge may appear as watery and thin, perhaps a little yellow or grey. A small soft red bump may appear at the end of the urethra, where the urethra has popped out a little bit from its usual casing. This is called a urethral caruncle. These signs and symptoms are all due to a lack of oestrogen.
What you can feel?
The first issue encountered early on is a lack of lubrication during sex or general feeling of dryness. This may be intermittent, but it will eventually persist as ongoing vaginal dryness. As the lining of the vagina thins, your vagina and vulva may start to feel very dry, itchy, or sore, and possibly start to sting. There may be small tears in the vagina or vulva due to a lack of flexibility and moisture. This can cause spotting.
You may experience urinary symptoms too, such as a sense of urgency and getting up at night to urinate. Urinary tract infections may also appear more often.
How to solve atrophic vaginitis?
Simply replacing oestrogen isn’t the answer, since unopposed oestrogen is very dangerous – a normal menstrual cycle includes other hormones that are triggered off by ovulation, but in the absence of working ovaries and their oestrogenic load, these other hormones also disappear. Oestrogen without progesterone to balance it out can leave oestrogen running rampant, which can contribute to oestrogen-dependent cancers.
Luckily, there are a handful of good options for getting your vagina back in good working order that do not include oestrogen. These treatments also work very well for women who are on breast cancer treatments that block all oestrogen in the body.
- Local oestrogen cream (with oestriol, E3 only) – most often prescribed by your doctor, applied daily or every few days. Works very well, but requires constant applications and may not be appropriate for everyone. E3 is the only oestrogen that doesn’t cause E1 and E2 to increase, contributing to cancers. It acts locally on the vaginal and vulvar tissue, which is ideal.
- Sexual activity – it has been observed that vaginal cells regularly engaged sexually function much better than those left alone. Use it or lose it has never been so true. This is an ongoing maintenance activity which may not suit everyone.
- Vaginal laser – laser beams can – without pain or incisions – trigger vaginal cells to produce more collagen and ‘come back to life’. These treatments work very well for a year or two to actually rejuvenate the very cells that are letting you down.
- Radiofrequency treatments – radio waves penetrate the tissue, acting like the lasers to stimulate cells to produce collagen, natural moisture, and tighteness.
At ENRICH, we have state-of-the-art vaginal equipment we use in a targeted vaginal rejuvenation treatment program. It is pain-free, there is absolutely no surgery, and the impacts are instant – and get better over the next few weeks and months as the cells regenerate.
Solve your vaginal atrophy symptoms today without oestrogen.