Health Matters With Doctor Jane: Can You Imagine A Future Without Sex?
Can you imagine if you were told you could never have sex again? How would that make you feel? Do you think your relationship would be strong enough to cope with the implications of this? Would fidelity become an issue? Would you be able to form new loving relationships?
Unfortunately, this is the reality for many women with a condition known as vaginal atrophy. It is a condition caused by oestrogen deficiency and until recently women have been too embarrassed to talk about it. But we should! It affects our partners too. If a man suddenly developed a condition, which caused his genitalia to shrivel up and dry out like a prune, Donald Trump would declare it “fake news” should it happen to him (maybe it has??), the stock markets would crash, the world would hold a two minute silence and the NHS would suddenly find a budget to rectify the problem.
What causes oestrogen deficiency?
The biggest culprit is the dreaded Menopause. 50% of menopausal women will suffer symptoms of vaginal atrophy. Looking on the positive side of menopause, we no longer need to worry about contraception, tampons, sanitary towels, white trousers and period pains. On the negative side, leading up to the menopause and for some years after, we can experience hot flushes, night sweats, mood swings, aches and pains, tiredness, annoying partners, teenage children. Medical research states that only hot flushes and night sweats, along with irregular and sometimes heavier than normal periods are actually due to decreasing levels of oestrogen. HRT is used for the treatment of hot flushes, night sweats and the prevention of osteoporosis in women with a strong predisposition to this terrible debilitating disease. For more information on osteoporosis visit www.nos.org.uk.
Other causes of oestrogen deficiency include anti-oestrogen drugs in the
treatment of breast and uterine cancer, removal of ovaries following ovarian cancer,ovarian failure resulting in premature menopause, damage to the pituitary gland and/or the hypothalamus in the brain.
What is vaginal atrophy?
The vagina is a muscular structure lined by the mucosa. The mucosa is made up of layers of connective tissue. It has an layer of epithelial cells which keep the vagina moist and protects it from infection. Situated below the epithelial cells are another type of cell called fibroblasts which produce elastin, a network of highly supportive fibres and collagen. When there is a deficiency of oestrogen the mucosa thins and all the good work provided by the epithelial cells and the fibroblasts disappears.
What are the symptoms of vaginal atrophy?
These can vary from woman to woman and can vary in severity. Symptoms experienced include pain on intercourse, dryness, itching, burning, irritation, recurrent infections, laxity and stress incontinence.
These can be extremely distressing and can cause extreme strain on intimate relationships or prevent new relationships forming due to sexual difficulties.
How can vaginal atrophy be treated?
Until recently, I too, as a GP could only offer my patients HRT and topical oestrogen in the form of gels, creams and pessaries applied directly to the vagina. For many of my female patients, the outcome of treatment was not entirely satisfactory, a bit messy and as soon as they stopped using their oestrogen, symptoms returned quickly. They were unhappy and I was frustrated. I started to research the concept of “vaginal rejuvenation” with CO2 laser therapy. After much reading, research, lectures, a conference and direct observation with a leading gynaecologist in this field, I decided to offer the Mona Lisa Touch CO2 laser therapy for the treatment of vaginal atrophy. The laser acts directly on the mucosa activating fibroblasts to produce more elastin and collagen and increasing the thickness of the epithelial cells, restoring the vagina to the function of its younger years before oestrogen deficiency.
What is the treatment like?
It is a painless procedure, which takes approximately 5 minutes to perform. A thin metal probe is placed inside the vagina and gently withdrawn as the laser acts directly on the mucosa. Normal activities can be resumed immediately. You must be period free and have an up to date, normal smear. Sexual intercourse can be resumed after 3 days. The procedure is repeated twice one month apart and the best results are seen at month three following the last treatment.
It is time for women in the UK to start talking openly about the impact that the menopause is having on the quality of their lives and their relationships. This is a discussion for both men and women. There
are many men who love our vaginas. It is time to love your vagina!