Many post-menopausal women find intercourse to be uncomfortable or painful, a condition called dyspareunia. While there are many causes, the most common reason for dyspareunia in women over 50 is vulvovaginal atrophy, the medical name for a vulva and vagina that no longer have the beneficial effects from estrogen that was present prior to menopause.
Lower estrogen levels significantly affect the vagina, impacting its ability to secrete lubricant, to expand and contract and to grow new cells. Over time, blood flow diminishes, and the vagina and vulva can atrophy, or shrink, as cells change and aren't replaced. The result can include soreness, burning or pain after sex, and, sometimes, bleeding after intercourse.
The good news is that vaginal atrophy is treatable, and your gynecologic healthcare provider can determine your best treatment option.
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As expected, if a lack of estrogen is behind vulvovaginal atrophy, then replenishing estrogen should help. Both systemic estrogens (oral pills and patches) and local estrogens (creams, rings and tablets applied to the vulva and/or vagina) may be utilized. However, most major medical organizations recommend starting with the local approach first because it keeps the estrogen right where it's needed, limiting effects on the rest of your body. Studies on the estrogen ring, cream and tablets find extremely high rates of improvement, with a large majority of women reporting significant improvement and many saying that their sexual comfort was restored, depending on the approach used.
The side effects of estrogen therapy can vary depending on the patient. When using estrogen creams, pills or rings, it is important to talk to your health care provider about any symptoms, such as: abnormal uterine bleeding, headache, stomach upset, bloating, nausea, weight changes, changes in sexual interest, breast tenderness, abdominal pain, back pain, respiratory infection, vaginal itching or vaginal yeast infections. If you have had breast cancer or a family history of breast cancer, you may likely be advised by your healthcare provider to avoid estrogen therapy and any decision to utilize hormone therapy should be discussed in conjunction with your oncology physician.
Over-the-counter lubricants designed to increase sexual comfort are widely available in both liquid or gel form and work by reducing friction. Application of a water-based or silicone-based lubricant to the vagina and vulva just before sex may help decrease this discomfort. A longer-lasting vaginal moisturizer, which is absorbed into the skin and can provide relief from vaginal dryness for up to four days, is another option. However, as with estrogen creams, etc., relief is temporary, and some patients dislike the associated moistness from the creams or moisturizers.
A revolutionary, non-invasive treatment is now available in St. Louis for the first time at Gynecologic and Reconstructive Surgery, LTD. The MonaLisa Touch delivers fractional CO2 energy to the vaginal wall tissue, revitalizing and restoring the vaginal tissue to treat symptoms as a result of low estrogen. Symptoms such as post-menopausal vaginal dryness and itching, painful intercourse, and more can be treated with laser vaginal revitalization. No surgery, no anesthesia, and no hormones make this 5 minute in-office treatment attractive to woman suffering through painful intercourse due to decreasing estrogen and menopause. Although some patients begin to feel an improvement after just one treatment, full results are expected after a series of three treatments, spaced about six weeks apart.
With 35 combined years of gynecologic medical and surgical experience, Dr. Dionysios Veronikis(link to his page) and Dr. Sara Wood (link to her page) provide the highest level of medical care and clinical results to their female patients, and their practice is excited to offer this treatment for women who are suffering from these life-altering changes.
Schedule a consult today at Women’s Laser Center of St. Louis to learn more about how MonaLisa Touch can improve your gynecologic health!
*Individual patient experience may vary
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