Why does menopause cause vaginal dryness

Menopause is a condition characterized by estrogen decline and results in numerous changes in the female organism. . The most prevalent symptom is vaginal dryness and affecting 60% of women in the postmenopausal period. In general, these symptoms lead to sexual dysfunction and consequently to reduced quality of life.

The changes that provoke all the signs and symptoms are correlated with a decline in estrogens and other sex steroids. In general, these changes cause alterations in the clitoris, vaginal vestibule, labia majora and minora, urethra, and bladder.

Generally, half of the menopausal and postmenopausal women presenting some signs and symptoms classic of Genitourinary symptom of Menopause ( GSM) . Commonly, the diagnosis is established on the clinical assessment. Under these circumstances, the vaginal epithelium becomes thinner, inflamed, often with erosions and bleeding. Clinical signs include vaginal include burning, dryness, loss of elasticity, petechiae, ulceration, inflammation, discharge fibrosis, and vaginal obliteration.

The most common vulvar signs include reduction in tissue thickness (loss of fat), labia agglutination, and loss of pubic hair.Coital activity can be uncomfortable in the postmenopausal period because of poor lubrication. In addition, there is a loss of rugae, occasionally stenosis, and the prepuce of the clitoris gets smaller.

The main objective of treating GSM is to alleviate symptoms provided by that period. First-line therapies for less severe symptoms include non-hormone vulvar and vaginal lubricants and long-acting vaginal moisturizers used regularly. Although not supported by clinical trials, regular, gentle vaginal stretching exercises may reduce GSM symptoms.

Prescription therapies include low-dose vaginal estrogens, vaginal DHEA inserts, and oral ospemifene. For women with moderate to severe dyspareunia associated with GSM with concurrent VMS, transdermal and oral HT are effective options. Pelvic floor muscle training significantly reduces Vulvo Vaginal Atrophy

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