Vaginal atrophy: how to relieve the symptoms?

Vaginal atrophy affects many women, but it is often underdiagnosed. Still a taboo subject, women rarely talk about it, associating their symptoms with "normal" discomfort during menopause or after treatment. However, this condition has consequences on quality of life and intimate relationships. Today, treatments exist, ranging from natural solutions to hormonal and medicinal treatments. Here is an overview of different approaches to relieve vaginal atrophy.

This term is used to describe a situation where, following a decrease in estrogen impregnation, the tissues of the vagina and/or vulva thin, losing their suppleness, elasticity and lubrication. Estrogens, the main female hormones, are indeed responsible for maintaining the thickness and moisture of the vaginal and vulvar walls.

This atrophy will result in a set of symptoms for women: dryness, irritation, pain, dyspareunia (pain during sexual intercourse) and sometimes an increased frequency of urination.

This can occur at any time of a woman's life, with a notable increase in risk with age. It is estimated that approximately 67 to 98% of women suffer from vaginal atrophy during menopause. It can also occur in younger women after childbirth, during breastfeeding, when taking certain medications (anti-acne, antihistamine or cancer treatment) or after surgical procedures.

In cases of vaginal atrophy, several treatments can be offered to relieve dryness, irritation and pain during intercourse, depending on the intensity of the symptoms and the hormonal context of each woman.

For many years, doctors have recommended oral or local hormonal treatments for vaginal atrophy. This is known as "Hormone Replacement Therapy" (HRT). The objective is to compensate for hormone loss and thus relieve the woman's symptoms. However, these hormonal medications present risks, particularly for certain women with a history of cancer or cardiovascular disorders, so it is necessary to consult a doctor before considering them.

Among traditional treatments, we can also mention vaginal lubricants and moisturizers, which, without hormones, aim to lubricate and relieve symptoms of vaginal dryness. Among moisturizing and lubricating products, those based on hyaluronic acid are highly recommended for their long-lasting moisturizing and soothing effects.

In 2021, the French National College of Gynecologists and Obstetricians (CNGOF) issued new practical recommendations for the management of vaginal atrophy in postmenopausal women.

They recommend using a local vaginal treatment as a first-line therapy based on lubricants and moisturizers and considering, only as a second step, if symptoms persist, hormonal treatment.

There are also new alternatives, such as laser, which involves sending micro-pulses to the vaginal walls to stimulate the regeneration of vaginal tissues. But it should only be considered after a doctor's evaluation and after trying lubricating and moisturizing treatments.

A large number of women suffering from vaginal atrophy are looking for natural solutions as alternatives to hormonal treatments. Among natural, moisturizing and protective alternatives, Ectoin, an osmoprotective molecule, was the subject of a patent application for vaginal atrophy in 2019*.

Ectoin protects the mucous membrane and lastingly restores deep vulvo-vaginal hydration thanks to its humectant action allowing it to attract water and retain it within the cells themselves.

Its clinical results and tolerability in patients with intimate dryness make it a reference molecule to offer women a natural alternative in cases of vaginal atrophy.

Ectoin is found in the composition of moisturizing lubricating gels in association with hyaluronic acid, a particularly interesting formulation to immediately hydrate and relieve intimate mucous membranes and allow women to regain lasting intimate comfort.

This article is for informational purposes only and does not replace a consultation or advice from your doctor.

• European Patent EP3498276B1
• Mac Bride MB, Rhodes DJ, Shuster LT. Vulvovaginal atrophy. Mayo Clin Proc. 2010 Jan;85(1):87-94
• Palacios S, et al. The European Vulvovaginal Epidemiological Survey (EVES): prevalence, symptoms and impact of vulvovaginal atrophy of menopause. Climacteric. 2018;21(3):286–291. 
• CNGOF- Update in gynecology. Menopause: SGM and topical estrogen treatments - pages 465-470
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