2 April 2021 Author : Augusta Matos Causes and symptoms of vaginal atrophy The decrease and interruption of ovaries estrogen production , which happens naturally with menopause, is the main cause of vaginal atrophy. However, vaginal atrophy can also occur in other circumstances when there is a decrease of the ovarian estrogens action on the genital tissues. This is what happens, for example, when an ovariectomy (surgical removal of the ovaries) is performed, or even in young women who have anovulatory cycles (in which there is no ovulation) or with prolonged amenorrhea (absence of menstruation) during the childbearing age. The estrogens produced by the ovaries contribute to maintain the vagina moisture, the thickness and elasticity of the tissues, and an adequate level of local acidity. Thus, the absence of its production and vaginal atrophy can give rise to several symptoms , for example: Discomfort and pain during sexual activity (dyspareunia); Itching and vaginal dryness sensation; Vaginal discharge; Urinary symptoms. There will be also a greater tendency for urinary and vaginal infections . Vaginal atrophy and its symptoms c ompromise the well-being and quality of life of many women and, when related to menopause, for longer and longer periods, considering the increase in life expectancy and years of sexually active life. Currently, several treatment options are available for vaginal atrophy, hormonal and non-hormonal. Gynecologists are the professionals to whom women with this problem should talk and who can advise them on the best treatment option in each cas e. Treatment of vaginal atrophy with hyaluronic acid Hyaluronic acid is a natural component of the skin and plays an important role in maintaining its structure and function. Due to its hygroscopic (water-absorbing) characteristics, it also contributes to maintaining the skin moisture. This compound is used in many products and procedures, namely in the field of aesthetics, and its effectiveness is mainly attributed to the effects of filling spaces and connecting to water. The treatment of vaginal atrophy with hyaluronic acid infiltration aims to stimulate the superficial layers of the skin and mucosa, make the tissues healthier and moisturize and tone the skin. Initially, this treatment was introduced in women treated for oncological diseases that entered menopause and could not treat vaginal atrophy with local estrogens, as they are hormonal products. The results obtained have led to the treatment being used also in other situations with good results. A recently published review paper, based on data from 335 women obtained between 2011-2017, refer that the results of treatment with hyaluronic acid are like those obtained with vaginal estrogens . The great advantage of applying hyaluronic acid over hormonal treatment is the convenience of the treatment: a single application performed by a doctor on an outpatient basis and the immediate restoration of hydration and functionality of the mucosa of the vagina. This approach thus represents an alternative, or even a first choice, in the treatment of vaginal atrophy and associated symptoms . Sources: Dos Santos CC, Uggioni ML, Colonetti T, Colonetti L, Grande AJ, Da Rosa MI. Hyaluronic acid in postmenopause vaginal atrophy: A systematic review . J Sex Med 2021;18:156-6. Meet the gynecology team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
