Vaginal atrophy treatment

What is vaginal atrophy?

Vaginal atrophy, also known as vulvo-vaginal atrophy (VVA) or atrophic vaginitis, is a condition that causes thinning and drying of the vaginal walls due to your body producing less oestrogen. Vaginal atrophy occurs mainly after the menopause, but can also happen at other times:

• During the years leading up to the menopause

• After surgical removal of both ovaries

• After radiotherapy of the pelvis

• After chemotherapy

• As a result of hormonal treatment for breast cancer.

Vaginal atrophy symptoms and diagnosis

Vaginal atrophy presents with a variety of vaginal and urinary symptoms:

• Vulval or vaginal burning or itching

• Vaginal discharge

• Burning sensation during urination

• Urgency with urination

• Recurrent water infections

• Urinary incontinence

• Light bleeding after intercourse

• Discomfort or pain during intercourse.

The diagnosis of vaginal atrophy will be made by your GP or a specialist Gynaecologist. It involves a vaginal examination during which your doctor will palpate and visually examine your pelvic organs. Your doctor can also check for signs of pelvic organ prolapse.

Although most women will experience similar symptoms during their lives, very few will seek treatment. Many women learn to live with the symptoms, even when they are distressing, because they may be embarrassed to discuss them with their doctor.

You should see a specialist if you experience vaginal symptoms, such as:

• Unusual bleeding
• Discharge
• Burning
• Soreness.

You should also make an appointment to see an expert if your symptoms have not resolved by using a vaginal moisturiser or water-based lubricant.

Treatment for vaginal atrophy

Moisturisers and oestrogen treatment for vaginal atrophy

Try a vaginal moisturiser to restore moisture in the vaginal area. The effects of a moisturiser generally last a little longer than those of a lubricant. You may also wish to use a water-based lubricant to reduce the discomfort during intercourse. However, these measures only provide temporary relief and do not treat the underlying condition.

Oestrogen treatment has traditionally been considered as the gold standard therapy for vaginal atrophy:

• Topical (vaginal) oestrogen is directly applied to the vagina and has the advantage of being effective at lower doses. In addition, it limits your overall exposure to oestrogen because a smaller amount reaches your bloodstream. It is more effective than oral hormonal regimens.
• Oral oestrogen carries more risks compared to the topical treatment without being superior in controlling your symptoms. Your doctor must explain the risks and the benefits of oral oestrogen. Many women are understandably reluctant to consider oestrogen treatment due to HRT (hormone replacement therapy) links to breast cancer.

MonaLisa Touch: a ‘game changing’ laser treatment

Many women are not eligible for hormonal treatment for their vulvo-vaginal atrophy, or they are not willing to take the risks of the treatment. Also, quite often the symptoms are resistant to all the above treatment options.

A game changing laser treatment for vulvo-vaginal atrophy has now been introduced with outstanding results. The MonaLisa Touch® laser therapy acts by reshaping and regenerating the atrophic vaginal tissue. It restores the healthy functionality of the vagina without the side effects of oestrogen.

It has also been shown to be helpful for many other disorders, such as:

• Mild urinary incontinence
• Vaginal laxity
• Postnatal disorders due to childbirth injury.

The procedure is painless, minimally invasive and without any risks to surrounding tissues. It takes only few minutes and is very well tolerated by most women.

For vaginal atrophy three treatments are recommended 4 to 6 weeks apart and then yearly. One study has shown improvements of 90% in vaginal laxity, 85% in vaginal itching, 84% in vaginal burning, 76% in dryness and 72% in pain during sex, after 3 sessions of MonaLisa Touch®.

The frequency of the procedures should be tailored to your needs, and will be assessed according to the cause and the severity of your symptoms.

MonaLisa Touch® laser therapy for vaginal atrophy has been shown to be effective. It is well supported by international publications from prestigious health institutes. There is also growing evidence to support the implementation of this laser therapy for conditions such as lichen sclerosus, vaginal or vulval inflammation and urinary disorders.

The procedure must be performed by specialists with advanced expertise in the treatment of vulval and vaginal disorders in order to make the correct diagnosis and personalise the treatment to your needs.