Gynecologist: Vaginal Atrophy Is Not Life-Threatening but Can Seriously Affect Quality of Life
Gynecologist Karlīna Elksne explains that falling estrogen can change the vaginal lining, causing dryness, burning and pain. The condition is not dangerous to life, but it can be treated if it affects wellbeing.
Vaginal atrophy, caused by a drop in the female sex hormone estrogen, is a common women's health issue, yet women still tend to speak about it reluctantly. This is discussed in the special issue "Women's Health" of the Latvian magazine "Par Veselību" by Karlīna Elksne, a gynecologist and obstetrics specialist who heads the gynecology unit at VCA (a Latvian medical provider) and teaches at Rīga Stradiņš University (RSU).
What happens in the body
Estrogen is produced mainly by the ovaries, and in small amounts by other tissues. It regulates the menstrual cycle and ovulation, helps maintain bone density, and affects the condition of skin, connective tissue, fat metabolism and blood vessels. It is also important for the health of vaginal and vulvar tissue, as it helps keep the lining elastic, moist and well supplied with blood.
When estrogen levels fall, for example during menopause, the lining becomes thinner, drier, more fragile and less elastic. Similar changes may occur after childbirth, during breastfeeding, or because of certain medications.
Symptoms
The most common complaint is vaginal dryness, followed by discomfort during intercourse and in daily life. The lining is more easily injured, so slight bleeding may occur during intercourse. Burning and irritation are also frequently reported, and sometimes discharge appears, including yellowish discharge, with or without an unpleasant odor. Painful intercourse can reduce desire for intimacy.
Elksne stresses that this is not merely a matter of discomfort: the vagina's natural defenses change, beneficial bacteria find it harder to provide protection, and the risk of infection rises. Atrophy is linked to more frequent infections, including urinary tract infections, and urinary incontinence may also appear.
Illness or part of aging?
The gynecologist says the answer largely depends on how the woman feels. "Nobody dies from vaginal atrophy," she says, but quality of life matters in medicine too. Menopause does not automatically mean pronounced atrophy: for some women the changes are so slight they go unnoticed, while for others they cause significant discomfort. After childbirth and breastfeeding, hormones usually return to normal and the situation improves on its own. If symptoms interfere with wellbeing and a woman wants to reduce them, it is a medical problem that can be addressed.
