Effective Treatments for Severe Vaginal Atrophy in Healthy Seniors

Q: Effective Treatments for Severe Vaginal Atrophy in Healthy Seniors

Hello Mr. <br>Steve： If we exclude psychological factors causing difficulties in sexual intercourse, vaginal atrophy after menopause can be treated with PREMARIN VAGINAL CREAM (estrogen vaginal cream), which is a hormone replacement method absorbed directly through the vaginal mu

Severe vaginal atrophy in my wife?

My partner and I are both 66 years old, and we are in good health, without hypertension or other diseases.
Two years ago, my partner began experiencing symptoms of vaginal atrophy, and we have been unable to engage in sexual intercourse since then.
She has seen a doctor and undergone oral hormone replacement therapy as well as used OptiLube lubricating jelly, but there has been no improvement.
We are both physically and mentally healthy, and we have a very loving relationship.
Is there any way to treat this condition so that we can regain our intimacy? Which specialist should we consult, a gynecologist? Thank you!

Steve, 60~69 year old female. Ask Date: 2017/10/05

Dr. Lin Manying reply Obstetrics and Gynecology

Hello Mr.
Steve: If we exclude psychological factors causing difficulties in sexual intercourse, vaginal atrophy after menopause can be treated with PREMARIN VAGINAL CREAM (estrogen vaginal cream), which is a hormone replacement method absorbed directly through the vaginal mucosa.
This medication requires a prescription from a physician, and it is recommended to consult a doctor at an obstetrics and gynecology clinic.
The Hualien Hospital of the Ministry of Health and Welfare cares about your health.

Reply Date: 2017/10/05

More Info

Severe vaginal atrophy, particularly in healthy seniors, can be a challenging condition that significantly impacts quality of life and intimate relationships. Vaginal atrophy, also known as vulvovaginal atrophy, is characterized by thinning, drying, and inflammation of the vaginal walls due to a decrease in estrogen levels, commonly occurring during menopause. While it is encouraging to hear that both you and your partner are in good health, the symptoms of vaginal atrophy can still be quite distressing.

Given that your partner has already tried oral hormone therapy and a lubricating jelly like OptiLube without success, it may be beneficial to explore additional treatment options. Here are several effective treatments for severe vaginal atrophy:
1. Local Estrogen Therapy: This is often the first-line treatment for vaginal atrophy. Local estrogen can be administered in the form of vaginal creams, tablets, or rings. These treatments deliver estrogen directly to the vaginal tissues, helping to restore moisture and elasticity without significantly affecting systemic hormone levels. Common products include estradiol vaginal cream (e.g., Estrace) and the vaginal ring (e.g., Estring).

2. Non-Hormonal Vaginal Moisturizers and Lubricants: While you mentioned using OptiLube, there are other options available that may provide better relief. Non-hormonal vaginal moisturizers can be used regularly to help maintain moisture in the vaginal tissues. Products like Replens or other similar moisturizers can be applied several times a week. Additionally, water-based or silicone-based lubricants can enhance comfort during intercourse.

3. Vaginal DHEA: Dehydroepiandrosterone (DHEA) is a hormone that can be converted into estrogen and testosterone in the body. A vaginal insert containing DHEA (e.g., Intrarosa) has been shown to improve vaginal atrophy symptoms in postmenopausal women.

4. Laser Therapy: Some clinics offer laser treatments that can stimulate collagen production and improve vaginal tissue health. This non-invasive procedure can help alleviate symptoms of vaginal atrophy and improve sexual function.

5. Pelvic Floor Physical Therapy: A specialized physical therapist can help with pelvic floor exercises that may improve vaginal tone and function. This can be particularly beneficial if there are any concerns about pelvic floor dysfunction.

6. Consulting a Specialist: Since your partner has already seen a doctor, it may be worthwhile to consult a gynecologist who specializes in menopause or sexual health. They can provide a comprehensive evaluation and tailor a treatment plan specific to her needs.

7. Counseling and Communication: Sometimes, the emotional and psychological aspects of intimacy can be just as important as the physical. Engaging in open communication about desires and concerns can help both partners feel more connected and may alleviate some anxiety surrounding sexual activity.

In summary, while vaginal atrophy can be a challenging condition, there are multiple treatment options available that can help restore vaginal health and improve intimacy. It is advisable to consult with a gynecologist or a healthcare provider specializing in menopause for a personalized treatment plan. With the right approach, it is possible to regain comfort and enjoyment in your intimate life.

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