Vaginal atrophy is a real thing in the real world??
April 9, 2013 8:10 AM   Subscribe

Vaginal atrophy (aka Atrohpic vaginitis) - what a name! However the symptoms match what I’ve experienced since puberty. Gyns over the years have told me that I just have to live with it. Most of the treatments I’ve found reference to are for post-menopausal women. Is there really nothing to be done until I hit menopause?

Forgive the TMI. Also, YANAD, YANMD, Etc.

I'm early 30's. Negative for STIs including HSV.

This was going to be a question about how I can stop repeated tears/splits between the labia that weaken the mucosa so I tear again in the same spot. I asked Doctor Google first. Now I’m surprised to find out there’s a name for what I’ve experienced all my adult life.

I pretty much don’t lubricate. Never have, no matter how aroused I am. I’ve slept with women and my body's responses are nothing like theirs before or after foreplay.

This leads to a pile of other issues: frequent yeast infections, bleeding/pain during sex, the painful repeated splits I mentioned, odd-colored discharges (that aren’t BV - we tested) that the doctors tell me are probably caused by low-level bleeding of the vaginal walls. Not pleasant.

I’ve asked at least four gynecologists over the years, and been told that I just have to live with this. “Lube during sex” is all they advise. That doesn’t help the broader issues.

Having found out that this has a name, I’ve been researching a bit. All the treatments I’ve found are marketed at post-menopausal women. Plus it seems to be a choice between inserting horse wee up there, or “feminine moisturisers” full of sodium hydroxide/lye/caustic soda (I’m looking at you Replens), glycerin (it burns us, Precious!), parabens and other scary ingredients. I’m not even sure they’d let me have the estrogen creams, since I’ve been barred from estrogen-based contraception on account of being in a stroke risk category.

I’m going to another Gyn appointment soon, and of course I’m bringing this up. But I want to be informed before I go in, given the dismissal of this issue in the past.

Is there anything that can treat these issues in younger, pre-menopausal women? Are the options I mentioned above the only ones? Has anyone here found ways to sort this issue out?

And forgive me, but if you did find a cure or long-term treatment for this, just how strange is it to get used to? I do wonder a bit how women deal with that level of moistness as an everyday thing, let alone when turned on.

Throwaway email:

posted by anonymous to Health & Fitness (12 answers total) 2 users marked this as a favorite
I'm much older than you, and I use Vagifem (the tablet) and Replens. Both work fine for me (I've never done HRT.) Sorry I have no more useful info. Replens doesn't seem any worse than any other lube.
posted by Ideefixe at 8:20 AM on April 9, 2013

repeated tears/splits between the labia that weaken the mucosa

Are you talking about the perineum ("taint") area? I'm wondering if there isn't some anatomical smallness there, leading to stretching, that exacerbates your natural lack of lubrication. Or perhaps some kind of chemical sensitivity that similarly makes things worse.

(As an example, I can tend to have sensitive skin, and trying to treat it with any of the oatmeal-containing lotions makes things way, way worse.)

Also, have you been to an endocrinologist to make sure all your hormonal levels are normal?
posted by gjc at 8:22 AM on April 9, 2013

I can't tell if your doc has suggested Premarin and you've dismissed it because of the horse urine connection, or if you just read about it. But it was prescribed for me after pregnancy and certainly seemed to help heal things up. So seems like it'd be worth a try if it's an option.
posted by leahwrenn at 9:19 AM on April 9, 2013

I have a history of vaginal dryness. I also have a mild form of cystic fibrosis. Discussions on CF lists/forums suggests this is pretty normal for women with CF. I consumed Celtic sea salt, coconut oil and glyconutrients to help me get well. One side effect is that I get a lot wetter than I used to and I no longer suffer (chronic) vaginal yeast infections. You might try consuming Celtic sea salt and see if that does anything for your issue.

Salt is a major component of mucus. Mucus membranes do not function like skin. Without healthy mucus coverage, they cannot keep out germs on their own the way skin does. If you can resolve the dryness, you should see less infection.

You might also request a sweat chloride test to see if you have "atypical CF," especially if you also have sinus, lung and/or gut issues. It is a non-invasive procedure. I think it used to run around $300, so not cheap but not $thousands either.

My skin also used to tear easily. I used to not be able to tear tags off of clothes without being cut up. I had to cut them off. So what you are describing is consistent with my condition.
posted by Michele in California at 9:37 AM on April 9, 2013 [2 favorites]

“feminine moisturisers” full of sodium hydroxide/lye/caustic soda

This sounds alarming, but in fact there is nothing wrong with a formula that uses a little sodium hydroxide (aka caustic soda or lye) for balancing the pH to the desired level. This chemical is absolutely harmless if its pH is correctly neutralized by an acid of some sort in the formula. In fact, it is far better to use a product whose pH is carefully adjusted with scary-sounding chemicals such as hydrochloride acid and sodium hydroxide than it is to use a product whose pH is too high or too low. Too much acid (a low pH) or too little acid/too much base (a high pH) causes discomfort to the vagina and vulva. Typically, you want the pH to be acidic, but not excessively so.

Some things that might help: a book called The V Book, a pH-correcting treatment such as boric acid suppositories, and (self) massaging the areas affected in order to help promote blood circulation.
posted by artistic verisimilitude at 9:40 AM on April 9, 2013 [1 favorite]

I wonder if using the syringes you usually insert anti candida creams with, filled with a good plain yoghurt, reasonably regularly, would make you feel better. Just a thought.
posted by taff at 9:41 AM on April 9, 2013

Have you ever been on hormonal birth control?

Oops, I see estrogen-based is out for you... but if you haven't pursued other hormonal options, like the progesterone mini-pill, maybe that's something to ask your doctor about?
posted by snorkmaiden at 10:20 AM on April 9, 2013

My gyn told me that topical estrogen is not absorbed in systemically, so it might be an option, though you can't use systemic estrogen. Many women find local estrogen to be very helpful for vaginal dryness due to menopausal change, though I'm not sure of your specific reason. Perhaps this is something you could discuss with your gyn?
posted by citygirl at 11:16 AM on April 9, 2013

I had postpartum dryness & fragility. Vagifem worked great.
posted by lizifer at 4:23 PM on April 9, 2013 [1 favorite]

If your gynecologist isn't taking you seriously, look to see if there is an OB/GYN who specializes in vaginitis near you. From what I have seen they are much more attuned to these issues and the subspecialty tends to draw people with a good bedside manner.
posted by treehorn+bunny at 8:40 PM on April 9, 2013

Most of the treatments I’ve found reference to are for post-menopausal women. Is there really nothing to be done until I hit menopause?

Yes because most of the women in whom this condition is recognised are post-menopausal. That is absolutely not a reason to be dismissing available treatments. You need to educate yourself and investigate each option as it pertains to your specific profile, probably in conjunction with a specialist.
posted by DarlingBri at 11:05 PM on April 9, 2013

Definitely go to a different doctor. Coconut oil is great, not using condoms helped too (or non latex spermicide free alternatives). Massage from a highly trained sports therapist or physio also helped, along with 'Ending Female Pain' by Isa Herrera - highly recommend.

I have overactive bladder, and once I was successfully medicated for that I supped getting cracks in my crotch. ??
posted by jrobin276 at 3:17 PM on April 10, 2013

« Older How do I get them not to hire me without getting...   |   Why am I doubting my relationship all of a sudden? Newer »
This thread is closed to new comments.