Vaginal Atrophy

What it is

Vaginal atrophy, now called genitourinary syndrome of menopause, is the set of changes in the vulva, vagina and urinary tract caused by the drop in estrogen during menopause — as well as after childbirth, during breastfeeding and in treatments that block hormones. The mucosa becomes thinner, drier and more sensitive, causing dryness, burning, itching, pain during intercourse, minor bleeding, more frequent urinary infections and urgency to urinate. Unlike hot flashes, these symptoms tend to persist without treatment. The assessment is made during the consultation, with a gynecological examination. Treatment may include vaginal moisturizers and lubricants, low-dose local estrogen, intimate laser and radiofrequency in selected cases, along with guidance on sexual health. The choice is individualized, taking into account each woman's history.

Most common symptoms

• Vaginal dryness and lack of lubrication
• Burning, itching or irritation in the vulva and vagina
• Pain during intercourse and minor bleeding afterward
• Urgency and increased frequency of urination
• Recurrent urinary infections
• Yellowish discharge or a change in odor
• Burning when urinating with no confirmed infection

Causes and risk factors

• Drop in estrogen at menopause, natural or surgical
• The postpartum period and breastfeeding
• Treatments that block hormones, such as for breast cancer
• Chemotherapy, pelvic radiotherapy or removal of the ovaries
• Smoking and the absence of regular sexual activity

How it is diagnosed

The assessment is made during the consultation, with attention to complaints of dryness, burning, pain during intercourse and urinary symptoms, which women often do not associate with menopause. During the gynecological exam, your gynecologist observes the typical signs: thinner, paler or redder mucosa, with loss of folds and reduced elasticity. Vaginal pH and examination of discharge help distinguish it from infections, and other tests are requested only if there is bleeding or suspicion of another condition.

How we treat it at Femi Saúde

Treatment starts with regular use of vaginal moisturizers and lubricants during intercourse, which relieve dryness and friction. When indicated, low-dose local estrogen is the baseline treatment, with minimal absorption into the body, and may be considered, with careful evaluation, even in selected cases after breast cancer. The gynecology team at Femi Saúde also offers intimate CO₂ laser and radiofrequency to improve the quality of the mucosa, especially for those who cannot or do not wish to use hormones. Pelvic floor physical therapy and guidance on sexual health complete the plan, defined according to each woman's history.

What we offer