As women age, their ovaries gradually stop ovulating and producing female hormones. Menopause is typically diagnosed when a woman has not had a period for a year. However, irregular bleeding can still occur due to various factors, and it may indicate underlying health concerns that should not be ignored.
Postmenopausal women may develop atrophic vaginitis due to decreased estrogen levels and hormonal changes in the vaginal tissue. This condition, also known as nonspecific vaginitis or senile vaginitis, arises when the body responds to the decline in estrogen.
Atrophic vaginitis is common, affecting nearly half of postmenopausal women in their 50s and 60s. It can also occur following ovarian removal surgery, chemotherapy, radiation therapy, or early menopause. The medical term Genitourinary Syndrome of Menopause (GSM) is used to describe vaginal atrophy and its associated symptoms.
Dr. Kim Woo Jeng, a gynecologist at The Catholic University of Korea, Incheon St. Mary’s Hospital, said that as women approach or go through menopause, their ovaries lose function, leading to decreased hormonal activity. This causes the vaginal lining to thin and become dry, resulting in symptoms like itching, burning, and pain—hallmarks of atrophic vaginitis.
Hormonal Deficiency: The Cause of Vaginal Dryness, Burning, and Discomfort
The primary cause is a lack of female hormones produced by the ovaries. The first noticeable sign is often reduced lubrication, which can be particularly apparent during intercourse. Many women also experience burning sensations and discomfort. Urinary symptoms, including painful urination, recurrent urinary tract infections, and urgency, are also common.
Persistent and severe itching can lead to continuous scratching, which can cause minor injuries and increase the risk of infection. If these symptoms occur, medical evaluation and treatment are necessary.
As the vaginal lining thins and secretions decrease, even minor irritation can lead to bleeding and painful intercourse. Some women describe the pain as severe, highlighting the need for understanding and support from partners.
Hormone replacement therapy is often recommended because hormonal deficiency is the primary cause of atrophic vaginitis. While antibacterial creams can help with infections, the primary focus is replenishing the missing hormones.
Dr. Kim explained that vaginal estrogen tablets or creams can effectively relieve symptoms of vaginal atrophy and reduce pain during intercourse. She noted that systemic absorption of these treatments is minimal, meaning they do not significantly increase the risk of breast cancer.
Overwashing Can Worsen Symptoms
The proper management of atrophic vaginitis in daily life is essential. Low-dose oral hormone therapy may also be beneficial, though older patients should discuss potential risks and benefits with their doctor.
Atrophic vaginitis is not caused by poor hygiene. Excessive washing or using harsh soaps can worsen symptoms. Frequent use of body washes or soaps can disrupt the natural acidic balance of the vagina, making it more susceptible to bacterial infections. While feminine hygiene products may offer temporary relief, they do not provide a long-term solution.
Doctors emphasize that atrophic vaginitis is not a severe health condition but a common occurrence in aging women. Many women hesitate to seek help due to embarrassment, but experts advise that symptoms should not be ignored.
Dr. Seo Eun Joo, an OB-GYN at Seran Hospital, explains, “Every woman goes through menopause, which brings physical and mental changes. While irregular bleeding is common, postmenopausal bleeding could signal inflammation or even cancer, so getting checked out is crucial.”
Dr. Seo added that after menopause, declining ovarian function leads to lower estrogen levels, causing the vaginal lining to become thinner and more prone to bleeding. It is essential to investigate any postmenopausal bleeding to rule out severe conditions such as uterine or ovarian disorders. Since irregular bleeding can have multiple causes, identifying the root issue as soon as possible is crucial.