Post-Menopausal Vaginal Health

Declining levels of estrogen with the onset of menopause have cascading physiological effects on vaginal tissue health that ultimately lead to vulvovaginal atrophy (VVA).  VVA is a common, underreported and severely overlooked medical condition whose symptoms will be experienced by most women at some point in their lives.  Of the 64 million post-menopausal women in the U.S., approximately 30 million experience and suffer from the symptoms of VVA.

Decreasing levels of estrogen cause (1) a thinning of the superficial cells and stratified squamous epithelial cells that line the vaginal mucosa and (2) a decrease in squamous epithelial glycogenation, resulting in a decrease of exfoliated, glycogenated cells.  Glycogen is an important biomolecule that is responsible for maintaining vaginal health.  The conversion of glycogen to lactic acid by Lactobacilli, the beneficial flora of the vaginal mucosa, is essential for maintaining the healthy, low vaginal pH.  In the absence of glycogen, the vaginal pH rises, resulting in a decrease in Lactobacilli and a potential for overgrowth of harmful bacteria that can lead to infection and inflammation.  Further, the decline in estrogen levels leads to decreased vulvovaginal blood flow, decrease mucous production, and decreased vaginal lubrication.

Genital symptoms include: dryness, loss of vaginal secretions, itching, burning, bleeding or spotting, dyspareunia (pain during sexual intercourse), vulvar pruritus, vaginal discharge.

Urinary symptoms include: dysuria, hematuria, incontinence, increase in urinary tract infections (UTIs).