Vaginal Atrophy – Part 1
BY KITT WALSH
I am way past-menopause, more than five years past, so I admit to experiencing that awful sinking feeling (the one that happens to me on roller coasters) when I wiped myself after urinating (only) a couple of weekends ago and bright red blood stained the tissue.
I waded up the tissue, pushed it gentle up inside and sure enough, the bleeding was vaginal. No mistake. Except it was a mistake. I was not supposed to be bleeding.
I dug through an old junk drawer until I found an errant tampon and wore it all night. The bleeding, though not copious, did not stop. I called my gynecologist who said if I soaked through a pad an hour to hie myself to an emergency room. If not, he’d see me on the following Tuesday.
Before Tuesday rolled around I became an “expert” via WebMD, which basically said the bleeding was caused by (a) cancer (b) rowdy sex or (c) vaginal atrophy. I could rule out (b), rowdy or otherwise, and I refused to think about (a) so I found myself rooting for (c) even though it sounded wrinkled and crone-like.
After an endometrial biopsy (ouch) and a vaginal ultrasound ruled out cancer (thank God), the doctor and I agreed, vaginal atrophy was probably the culprit.
Here’s what that means for us post-menopausal women:
Vaginal atrophy (atrophic vaginitis) is thinning, drying or inflammation of the vaginal walls due to your body having less estrogen (thus the post-menopause part). It is sometimes called genitourinary syndrome of menopause (GSM) because it can make for some unpleasant urinary problems too.
Here are some of the signs you may have vaginal atrophy:
- Vaginal dryness, burning or discharge
- Genital itching
- Burning or urgency with urination
- Frequent urinary tract infections
- Discomfort or decreased lubrication with intercourse
- Light bleeding
According to the Mayo Clinic, nearly half of us experience some symptoms of vaginal atrophy though many women are too embarrassed to go to the doctor. (Honey, if I am bleeding from my insides, I am headed to the doctor!)
The missing estrogen makes our vaginal tissues less elastic, thinner and drier (and therefore more fragile) or, in my case, as a thyroid patient, a needed change in medication dried up my skin, hair and yes—insides—and probably helped cause me to tear a little.
A healthy sex life (alone or with a partner) actually is good for avoiding vaginal atrophy, thus the smart-ass question I asked the doctor, “Could the bleeding just be caused by rust?” wasn’t so smart-ass after all.
Other things that put you at risk are smoking (affects your blood circulation so your tissues don’t get enough oxygen), no vaginal birth and frequent urinary tract infections or vaginal infections (causing changes to the acid balance of your vagina).
How a doctor establishes if you have vaginal atrophy is by;
- A pelvic exam, where he or she palpates your pelvic organs and looks at your vagina and cervix. (My doctor found a small laceration, or crack, in my vaginal wall). The doctor will also check for signs of pelvic organ prolapse that could be stretching the support tissues of your uterus.
- An acid balance test, which uses a paper strip to see how acidic your vagina is (a urine test will be given, too, if you are having any urinary symptoms.)
And if you are bleeding:
- An endometrial biopsy, where an instrument is passed through your cervix and a small sample of your uterine lining is taken to test for cancer.
- A vaginal ultrasound, where a long ultrasound rod (topped by a condom, which made me laugh) is inserted into your vagina to test for tumors or fibroids.
None of us like to think of getting old. To some of us it means we are dried up, unsexy, and we have visions of wrinkled and toothless old women we’ve known. But the times- they-are-a-changing. Tomorrow, we will discuss treatments for this condition. Our ability to love and be loved, to be sexy for the entire rest of our lives, and to be vibrant, interesting and sensual creatures as long as we draw breath is open to us now—as long as we are still drawing breath, that is.