Effective Treatments for Vaginal Adhesions and Restoration of Normal Function

How to treat vaginal adhesions and restore the vaginal opening to normal?

I have severe urethritis and vaginal inflammation caused by estrogen deficiency and decreased immunity.
The gynecology and infectious disease departments at Kinmen Hospital prescribed antibiotics and provided a vaginal antiviral ointment for me.
However, three weeks later, my husband noticed that my vaginal opening had become smaller, and during intercourse, he was unable to penetrate, resulting in a vaginal tear.
The next day, when I sought examination and treatment at an obstetrics and gynecology hospital, the doctor informed me that my vaginal opening had severe adhesions, causing it to narrow.

I would like to ask:
1.
How can this condition be treated to separate the adhesions and restore the vaginal opening to normal?
2.
Is vaginal reconstructive laser surgery necessary to successfully restore the vaginal opening to its normal size, or can applying vaginal hormones suffice to separate the adhesions?
3.
If laser surgery is required, is it covered by health insurance or is it out-of-pocket? What is the approximate cost?
4.
If vaginal hormone therapy is used, how long will it take for the adhesions to separate and the vaginal opening to return to normal?
I appreciate your clarification.
Thank you!

Sophia, 50~59 year old female. Ask Date: 2022/12/05

Dr. Lin Lixuan reply Obstetrics and Gynecology

Postmenopausal urogenital syndrome can lead to atrophic vaginitis due to decreased estrogen levels, resulting in vaginal dryness that may cause inflammation and infection, as well as discomfort during sexual intercourse.
It is recommended to seek evaluation at a nearby obstetrics and gynecology clinic.
First-line treatment options include vaginal hormone creams or taking probiotics for the intimate area to reduce recurrent perineal infections.
Vaginal laser surgery is currently not covered by health insurance, and the out-of-pocket costs vary by medical facility due to differences in equipment.
Recovery time after treatment varies from person to person, and it is advisable to have regular follow-up evaluations with an obstetrician-gynecologist.

Reply Date: 2022/12/05

More Info

Vaginal adhesions, particularly those resulting from severe inflammation, hormonal deficiencies, or infections, can lead to significant discomfort and complications, including narrowing of the vaginal opening. This condition, often referred to as vaginal stenosis, can occur due to scarring or fusion of the vaginal walls, which may be exacerbated by factors such as estrogen deficiency, particularly in postmenopausal women or those with hormonal imbalances.

1. Treatment Options for Vaginal Adhesions: The primary goal in treating vaginal adhesions is to separate the adhered tissues and restore normal anatomy and function. Treatment options may include:
- Hormonal Therapy: Local estrogen therapy, such as vaginal estrogen creams or tablets, can help restore vaginal tissue health and elasticity. This approach is often the first line of treatment, especially for those with estrogen deficiency. Hormonal therapy can promote healing and may help in separating the adhered tissues over time.

- Surgical Intervention: In cases where adhesions are severe and do not respond to hormonal therapy, surgical options may be considered. Procedures such as vaginoplasty or laser surgery can be performed to carefully separate the adhered tissues and restore the vaginal opening. Laser surgery can be particularly effective as it minimizes damage to surrounding tissues and promotes quicker healing.

2. Need for Surgical Intervention: Whether surgical intervention is necessary depends on the severity of the adhesions and the response to conservative treatments. If hormonal therapy alone does not yield satisfactory results, surgical options may be warranted. It is essential to have a thorough evaluation by a gynecologist to determine the best course of action tailored to your specific situation.

3. Insurance Coverage and Costs: The coverage for surgical procedures can vary widely based on the healthcare system and individual insurance plans. In many cases, laser surgery for vaginal adhesions may not be covered by insurance, and patients may need to pay out-of-pocket. Costs can vary significantly depending on the facility, the complexity of the procedure, and geographic location. It is advisable to consult with your healthcare provider and insurance company to get a clear understanding of potential costs and coverage options.

4. Duration of Hormonal Therapy: The time required for hormonal therapy to effectively reduce adhesions and restore normal vaginal function can vary. Some patients may notice improvements within a few weeks, while others may require several months of consistent treatment. Regular follow-up with your healthcare provider is crucial to monitor progress and make any necessary adjustments to the treatment plan.

In conclusion, addressing vaginal adhesions involves a multifaceted approach that may include hormonal therapy and, if necessary, surgical intervention. It is vital to work closely with a healthcare provider to determine the most appropriate treatment plan based on the severity of the condition and individual health needs. Regular follow-ups and open communication with your healthcare team can help ensure the best outcomes and restore normal vaginal function.

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