What treatments are available for treating the symptoms of vulvovaginal atrophy?

What treatments are available for treating the symptoms of vulvovaginal atrophy? When do you start treatment, & how long do you treat?"

Vulvovaginal atrophy (VVA) is a condition which is characterised by thinning, drying, and inflammation of the vaginal walls, mainly because of low oestrogen level and usually in postmenopausal women. For VVA, symptoms include vaginal dryness, itching, burning sensation and pain during sexual intercourse, and the treatment is meant to manage these symptoms.

 Treatment Options

 Local Estrogen Therapy:

 Medications: Vaginal estrogen comes in different forms; creams for instance, Estrace, tablets such as Vagifem, vaginal rings such as the Estring plus there are suppositories.

 How It Works: Estrogen plays the roles of maintaining the structural integrity of the vaginal epithelium, increasing keratinization, and the symptoms are relieved.

 Duration: Generally, local estrogen therapy may be employed as a long-term treatment and there would be a periodic check-up on the patient to assess the dosage if necessary at all.

 Systemic Hormone Replacement Therapy (HRT):Systemic Hormone Replacement Therapy (HRT):

 Medications: For hot flushes, first choice treatment is not hormonal because it is associated with an increased risk HRT is given systematically by oral tablets, patches or gels if symptoms are severe or other menopausal symptoms are needed at the same time.

 How It Works: HRT is given based on the general estrogenic deficiency and thereby manages VVA complaints together with other symptoms of the climacteric period.

 Duration: It applies duration of existence; generally used for a few years, proportional to the specific requirements of the patient and his or her risk factors.

 Non-Hormonal Vaginal Moisturizers and Lubricants:Non-Hormonal Vaginal Moisturizers and Lubricants:

 Medications: Lotions such as over the counter Replens or K-Y Jelly.

 How It Works: These products are useful in giving some measure of relief to the dryness and friction experiences during intercourse.

 Duration: Should be taken upon the first signal of any of the associated symptoms in which case the intensity will determine the dosage to be taken.

 Selective Estrogen Receptor Modulators (SERMs):Selective Estrogen Receptor Modulators (SERMs):

 Medications: Ospemifene is a case in point.

 How It Works: SERMs have affinity to estrogen receptors in the vaginal tissues which in some way help to correct symptoms of VVA.

 Duration: Used in the long-term with patients; evaluations are made periodically to check the impact.

 Lifestyle Modifications:

 Approaches: Sexual intercourse, proper intake of liquids and other fluids, and the avoidance of irritants such as creams or scented wipes, as well as douches can be very effective in controlling the symptoms.

 Duration: They are used and continued on as part of symptom control.

 Pelvic Floor Physical Therapy:

 Approaches: The exercises and methods to use in enhancing the vaginal muscles flexibility and strength.

 Duration: Therapy duration is short in some cases but can extend to the several sessions over the course of few months.

 When to Start Treatment

 Symptom Onset: The aim of the treatment is the satisfaction of the patient although it can be initiated when some symptoms of VVA (dryness, itching, burning) become troublesome for the patient in his /her daily life .

 Diagnosis: In the majority of cases, a healthcare provider will establish diagnosis with help of history, symptoms, and physical examination.

 How Long to Treat

 Individualized: This form of treatment may take short timeframe of few months or may even take few years depending on the incessant manifestation of symptoms and responses of the patients to the rehabilitative interventions. Local estrogen therapy is commonly of a long duration and can be maintained as long as the patient benefits from the treatment and as long as side effects are minimal.

 Regular Follow-Up: People undergoing this treatment should attend follow-up appointments from time to time to determine the effectiveness of treatment, intolerable side effects, or if new adjustments can be done to the treatment plan.

 References

 The hospital has complied with this requirement by getting membership to the American College of Obstetricians and Gynecologists (ACOG). (2020). "Vulvovaginal Atrophy. "

 Mayo Clinic. (2023). "Vulvovaginal atrophy treatment. "