Vaginal dryness
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Vaginal dryness (vaginal atrophy, genitourinary syndrome of menopause – GSM) is a clinical condition resulting from insufficient lubrication of the vaginal mucosa, most commonly associated with estrogen deficiency. It leads to structural and functional changes in the epithelium, such as its thinning, reduced elasticity, and a decrease in glycogen levels, which disrupts the physiological microflora. This symptom may occur not only during menopause but also in younger women, as a result of hormonal, pharmacological, or systemic factors. Vaginal dryness significantly affects the quality of life, sexual health, and increases susceptibility to infections and micro-traumas.
Vaginal dryness – causes
The etiology of vaginal dryness is multifactorial and includes both hormonal changes, as well as environmental and systemic factors. Estrogen deficiency plays a key role, leading to atrophy of the vaginal stratified squamous epithelium and reduced mucus secretion.
The most common causes include:
1. Hormonal disorders:
- menopause and perimenopause (the most common cause),
- the postpartum period and lactation (reduced estrogen levels),
- anti-estrogen treatment (e.g., in oncological therapy),
- the use of certain contraceptives.
2. Iatrogenic factors (treatment-related):
- radiotherapy and chemotherapy,
- surgical procedures (e.g., removal of the ovaries),
- chronic use of antihistamines, antidepressants, or diuretics.
3. Systemic diseases:
- autoimmune diseases (e.g., Sjögren's syndrome),
- diabetes,
- chronic genitourinary tract infections.
4. Lifestyle and environmental factors:
- chronic stress and psychosomatic disorders,
- improper intimate hygiene (e.g., use of harsh detergents),
- tobacco smoking,
- insufficient hydration of the body.
Pathophysiologically, there is a reduction in tissue blood supply, a decrease in collagen and elastin production, and disturbances in the vaginal microbiome, which predisposes to infections and inflammation.
Vaginal dryness – treatment
Therapeutic management depends on the cause, the severity of symptoms, and the patient's age. Treatment includes both pharmacological methods and modern regenerative technologies.
1. Hormonal treatment:
- local estrogen therapy (creams, ovules, vaginal rings),
- systemic hormone replacement therapy (HRT) – in selected cases.
Estrogens restore the normal structure of the epithelium, improve its blood supply, and increase mucus production.
2. Non-hormonal preparations:
- lubricants (temporary moisturization),
- moisturizing preparations (regular use),
- vaginal hyaluronic acid – regenerative and water-binding effect.
3. Causal treatment:
- therapy of comorbid diseases,
- modification of pharmacotherapy (if possible),
- psychosexual support.
4. Modern procedural methods:
- laser therapy (e.g., fractional CO₂ laser, Er:YAG) – stimulation of mucosal regeneration,
- radiofrequency (RF) – improvement of blood supply and tissue tension,
- platelet-rich plasma (PRP) – regeneration and improvement of tissue trophism.
Treatment should be individualized and preceded by gynecological diagnostics, taking into account contraindications to hormonal therapy.
What for vaginal dryness
Modern aesthetic medicine and regenerative gynecology offer a wide spectrum of solutions supporting the treatment of vaginal dryness, especially in patients who do not qualify for hormone therapy or expect additional improvement in quality of life.
1. Regenerative and biostimulating therapies:
- monopolar radiofrequency (INDIBA) – uses a current with a frequency of 448 kHz, which:
- improves microcirculation,
- stimulates fibroblasts to produce collagen,
- increases tissue hydration and elasticity,
- has anti-inflammatory and regenerative effects.
This technology is used in the revitalization of intimate areas, improving the trophic state of the mucous membrane and reducing symptoms of dryness.
2. Other procedures used in clinical practice:
- treatments using hyaluronic acid (mesotherapy of intimate areas),
- laser vaginal rejuvenation,
- platelet-rich plasma (PRP) therapy,
- carboxytherapy (in selected indications – improvement of blood supply).
3. Supportive management:
- regular use of moisturizing preparations,
- avoiding irritating hygiene products,
- diet rich in phytoestrogens and omega-3 acids,
- sexual activity – promotes maintaining proper blood supply to the tissues.
In clinical practice, the best results are achieved through combination therapy – combining pharmacological, procedural methods and lifestyle changes. Such an approach allows not only for the reduction of symptoms, but also for real tissue regeneration and improvement of the patients' quality of life.