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Vaginal Atrophy Part 2 – Treatments

Vaginal Atrophy Part 2 – Treatments
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Last time in this space, I wrote about my adventures with Vaginal Atrophy, a common condition affecting women post-menopause that caused, in my case, some very scary vaginal bleeding from a well supposedly run dry.

This occasioned a quickly scheduled trip to the gynecologist where an endometrial biopsy (the “ouch” I wrote previously is worth repeating) and a vaginal ultrasound (no pain but filling my bladder to near bursting for the test was no fun) to rule out cancer were performed.

Once cancer was omitted from the possible causes of the bleeding (thank God) and rowdy sex, the other culprit for post-menopausal bleeding, was also (sadly) checked off the list, that left vaginal atrophy—or what I called “rust”.

What it comes down to is that our vaginal tissues thin out from lack of estrogen and crack or tear easily—thus the bleeding. Oddly, well lubricated sex makes the tissues more elastic and less prone to damage but, failing regular romps in the hay (or in addition to them,) your doctor will undoubtedly prescribe some methods to help avoid the bleeding, dryness, burning, discharge, itching or urinary tract infections that vaginal atrophy may cause.

Here, in more detail, are some of the remedies:

Those that require no prescription:

Vaginal water-based lubricant for use during sex. Popular ones include Astroglide and K-Y Touch. Don’t use Vaseline or any petroleum-based product as it can break down condoms. Also avoid any with glycerin as you may prove sensitive to that ingredient.

Vaginal moisturizer (not a lubricant). Go for unscented ones like Replens, Vagisil Feminine Moisturizer or Hyalo Gyn to be used every other day.

Note, you might want to wear a daily liner pad to catch any overflow of your new artificial “dampness”.

Non-systemic remedies, which are effective at, lower doses and never reach your bloodstream:

Vaginal estrogen cream: You insert this cream directly into your vagina with an applicator, usually at bedtime. Your doctor will let you know how much cream to use and how often to insert it. Typically you will use it daily for one to three weeks and then one to three times a week thereafter. Although creams may offer faster relief than do other forms of vaginal estrogen, they can be messier.

Vaginal estrogen tablets: You use a disposable applicator to place a vaginal estrogen tablet in your vagina. Your doctor will let you know how often to insert the tablet. You might, for instance, use it daily for the first two weeks and then twice a week thereafter.

Wear a pad to bed when using cream or tablets and, while we are on the subject, it is probably time to give up ever inserting a tampon up there. The pain that caused me when I grabbed one to stop the initial bleeding was memorable and probably made the bleeding worse, or so speculated my doctor.

A vaginal ring: You or your doctor inserts a soft, flexible ring into the upper part of the vagina. The ring releases a consistent dose of estrogen while in place and needs to be replaced about every three months. Many women like the convenience this offers. A different, higher dose ring is considered a systemic rather than topical treatment.

Systemic remedies which are absorbed in your bloodstream and are therefore riskier:

Estrogen pill

Estrogen patches

Estrogen cream

Ask your doctor about the risks and be sure to tell her/him if you have a family history of or have had breast cancer.

Your doctor will prescribe progestin along with estrogen if you haven’t had your uterus removed (hysterectomy). Oral progesterone, which is chemically identical to the hormone your body produces (bioidentical), is often preferred. Combination estrogen-progestin patches also are available.

If you don’t have a uterus, estrogen alone can be used. Talk with your doctor to decide if hormone treatment is an option for you, taking into account any medical issues and family medical history.

Other things that may help

You may also want to have your thyroid checked. Being low in that hormone can dry up your skin, hair, eyes and yes, insides. Also, any health food store will be happy to tout the affects of yam and black cohosh and other natural remedies. Tell your doctor if you are partaking of any such natural supplements as they can interfere with prescribed medicine.

So, the point of all this is, our interior landscapes are changing and vaginal atrophy might be one of the ways we notice such change, in a rather startling way. Blood always gets my attention (and it should you, too.) If you are bleeding, get to a doctor and, if you find you have vaginal atrophy, thank whomever you thank that it’s not cancer. Then get on with dialing up what nature has dialed down and get juicy again.


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