Vaginal Atrophy and RenovaLaseTM treatment

 

What is vaginal atrophy?

Vaginal atrophy, also known as either ‘Atrophic Vaginitis’ or ‘Urogenital-atrophy’ is the term given to inflammation of the vagina (and the outer urinary tract) due to the thinning, shrinking and inflammation of the vaginal tissues, along with a reduction in lubrication.

The underlying cause is a decreased level of the hormone Oestrogen, which is a common result of either menopause, peri-menopause, breast-feeding and is frequently seen in patients receiving chemotherapy.

Vaginal atrophy symptoms will be well known to a large percentage of post-menopausal women, who will have noticed changes in their vagina and genital area, leading to dryness, itching, vaginal irritation and pain during intercourse (dyspareunia), and quite often urinary bladder symptoms as well. These symptoms can have an adverse impact on sexual function which can be already partially compromised by a loss of libido due to the hormonal imbalance

Prior to the menopause (or other triggering factor), the skin and tissues around your vagina are kept supple and moist by fluids and mucus. These are made by glands at the neck of your womb. Oestrogen (the female hormone) affects these glands. Oestrogen also affects the tissues in and around your vagina, causing the lining of your vagina to be thicker and more elastic. Oestrogen also stimulates the cells that line your vagina to produce ‘Glycogen’, a compound which encourages the presence of helpful germs (bacteria) which protect your vagina from infections.

After the menopause, your ovaries make less oestrogen. The lack of oestrogen leads to thinning of the tissues around your vagina and a reduction in the number of glands that make mucus. There may also be a loss of some fat tissue from around your genital area. This may make the area also look slightly different to how it was before the menopause.

In summary, the menopause-induced hormonal changes make the vagina shorter, less elastic and drier. These changes usually take months or years to develop after the menopause and vary from woman to woman. Atrophic vaginitis is the medical term for the condition when these changes produce troublesome symptoms.

 

What symptoms can occur?

The changes described above can occur without causing any symptoms or discomfort. However, some of the following symptoms may develop in some women. It is worth repeating that menopause is not the only triggering factor and these problems can also be caused by other medical conditions.

  • Pain when you have sex. This may occur because your vagina is smaller, drier and less likely to become lubricated during sex compared with how it was before the menopause. Also, the skin around your vagina is more fragile, which can make the problem worse.
  • Bleeding during and after sexual intercourse. For similar reasons as above.
  • Discomfort - if your vulva or vagina is sore and red.
  • Vaginal Dryness – as a result of less mucosa secreting cells operating.
  • Vaginal Discharge - There may be a white or yellow discharge. Sometimes this is due to an infection. Infection is more likely if the discharge is smelly and unpleasant.
  • Itch - The skin around your vagina is more sensitive and more likely to itch. This can make you prone to scratching, which then makes your skin more likely to itch, and so on. This is called an itch/scratch cycle which can become difficult to break, and can be distressing.
  • Urinary problems. Atrophic vaginitis may contribute to various urinary problems. This is because of thinning and weakening of the tissues around the neck of the bladder, or around the opening for urine to pass (the urethra). For example, urinary symptoms that may occur include an urgency ro urinate and recurring urinary infections.


What treatments are available for atrophic vaginitis?

Since symptoms are variable; treatment options are also variable, depending on which symptoms are the most troublesome.

Hormone Replacement Therapy (HRT)

Because the problem is mainly due to a lack of oestrogen, it can sometimes be helped by replacing the oestrogen in your tissues. This means taking oestrogen in the form of a tablet, gel or patches, but some women don't like the idea of takingHRT. There are undoubtedly both advantages and disadvantages of using HRT and women would be advised to investigate the option fully if they are contemplating such treatment.

Sometimes a cream, pessary or vaginal tablet or ring containing oestrogen is prescribed. A pessary is a small soluble block that you insert into your vagina with a small applicator. The ring is a soft, flexible ring with a centre that contains the oestrogen hormone. This ring releases a steady, low dose of Oestrogen each day and it lasts for three months.

These preparations work to restore oestrogen to your vagina and surrounding tissues without giving oestrogen to the whole body. Usually the treatment is used every day for about two weeks, and then twice a week for a further three months. After this the effect of the treatment is usually assessed by your doctor. This treatment usually works well but the symptoms may recur sometime after stopping the treatment. Repeated courses of treatment are often necessary. These preparations should not be used as additional lubrication during sex; lubricating gels should be used instead. One reason for this is that the oestrogen creams may damage latex condoms and diaphragms.

 

Laser Treatment for Vaginal Atrophy.

‘Fotona’ are recognised as the manufacturers of the best lasers in the world. Over recent years, they have developed a minimally-invasive laser technique called “RenovaLase” which has had remarkable success in the treatment of Vaginal Atrophy.

RenovaLase works by gently heating the vaginal canal, without causing thermal damage, resulting in regeneration and repair of the connective tissue, and an increase in epithelial thickness. This leads to an improvement in the discomfort caused by vaginal atrophy together with functional restoration of the vaginal mucosa .

 

Advantages of RenovaLase laser treatment:

  • Functional restoration of the vaginal mucosa.
  • No long-term hormone therapy; therefore ideal for those who have a family history of cancer, hormone-dependent cancer, melanoma, breast or endometrial cancer who cannot use hormones.
  • No need for anaesthesia.
  • Outpatient treatment. No hospital stay.
  • No complications have been reported in any clinical study.
  • Treatment in just one or two sessions.