WHAT IS MEANT BY ATROPHY OF THE LOWER GENITAL TRACT?
Oestrogen deficiency results in atrophy of both the vagina and urethra . Symptoms of atrophic vaginitis include vaginal dryness, dyspareunia and recurrent bacterial infections. Atrophy of the urethra leads to recurrent episodes of urinary frequency, dysuria and urgency.
WHAT ARE THE EFFECTS OF OESTROGEN DEFICIENCY ON THE VAGINA?
The inner lining of vagina becomes thinner and loses its elasticity. There is reduction in the lactobacillus population and the vaginal pH increases, reducing the resistance of the vagina to pyogenic organisms. There is increased predisposition to bacterial infection and loss of vaginal secretions which some women are aware of all the time but many others notice most with intercourse. Finally, the vagina tends to become shorter and narrower.
DO THESE CHANGES AFFECT LIBIDO?
Oestrogen deficiency can contribute to loss of libido after the menopause. A vicious circle can arise whereby oestrogen deficiency leads to vaginal dryness causing dyspareunia, which in turn, leads to less interest in sex, then less intercourse and even greater atrophy and more discomfort. Treatment of the oestrogen deficiency state can break this circle.