Vaginal and Clitoral Atrophy
Vaginal atrophy, also called atrophic vaginitis, is thinning, dryness and inflammation of the skin lining of the vagina due to a decrease in estrogen. This decrease can occur during breastfeeding, after surgical removal of one or both ovaries, after pelvic radiation, following chemotherapy, and particularly during perimenopause/menopause. Other symptoms include vaginal itching, burning with urination, and urinary tract infections. Many women often suffer in silence with this condition before speaking to a medical provider about treatment options. Rest assured that assistance and treatment is possible! For many women, vaginal atrophy makes intercourse painful, thus leading to a loss of interest in sex. A number of over-the-counter vaginal moisturizers and lubricants such as Pjur Woman, Sliquid H2O, or Blossom Organics Natural can be helpful for those women with minor symptoms and for those concerned about using hormones.
Medical Treatment for Vaginal Atrophy
The medical treatment for vaginal atrophy includes the use of local, low-dose estrogen creams, vaginal estrogen rings, estrogen suppositories and estrogen pills, patches and gels. These therapies are effective and generally well tolerated. Side effects can, however, include vaginal bleeding, breast discomfort, nausea, and thickening of the lining of the uterus. The lower the dose of estrogen, the fewer and less severe the side effects. Researchers are working to develop other non-hormonal treatments because of concerns that even small doses of estrogen could increase the risk of breast and uterine cancer.
All tissues of the body depend on good blood flow for their nourishment and functioning, and the vagina is no different. Engaging in regular sexual activity, either with or without a partner, increases blood flow to the clitoris and vagina to keep those tissues healthy. Similarly, engaging in regular exercise helps by increasing general blood circulation as well as increasing and maintaining the production of testosterone.
Many of the devices listed in this section stimulate and help promote bloodflow to the clitoris. These devices are generally intended for external use but, if lubricant is desired, we have also suggested several gentle, natural-ingredient (and sometimes organic) lubricants that can help with intercourse, to make it more enjoyable.
The clitoris, a female sex organ, is the most sensitive part of a woman’s body, containing nearly 8,000 sensory nerve endings; twice as many as found in the human penis. The clitoris is the only part of a woman’s anatomy designed exclusively for sexual pleasure. It is composed of soft tissue that fills with blood during sexual arousal. This tissue is maintained, in part, by the hormone testosterone and is dependent on adequate blood flow.
When a woman's level of testosterone drops, such as occurs with menopause or the use of hormonal birth control, she could experience a decrease in size, function, and sensitivity of the clitoris over time: a condition known as clitoral atrophy. The use of bio-identical testosterone in a cream, pill or injection can be helpful in restoring not only the size and sensitivity of the clitoris, but a woman’s sense of well-being, sexual libido and vital energy as well. Within this category, we suggest several warming lubricants and stimulating gels such as Intimate Organics Melt and Intense, Sliquid Organics Stimulating O Gel and ON for Her Arousal Oil to encourage bloodflow and sensitivity to the clitoris. The use of a vibrating device that focuses sensation on the clitoral area, such as the Form 2, the Revel SOL or the We-Vibe Touch can also help provide stimulation and make an otherwise frustrating experience more relaxing and playful.
Testosterone supplementation is carried out by a healthcare provider following lab testing to determine, and then monitor, a woman’s blood levels of the hormone. Many women fear testosterone replacement because they have heard it can cause significant masculinizing effects such as growth of body and facial hair, a deepening of the voice and significant enlargement of the clitoris. These side effects tend to occur when the dosage is too high and can be reversed by lowering the dose or stopping the treatment.
Books included in this section, including Healing Painful Sex, talk directly about this condition while other book suggestions such as Sex Over 50 and the V Book address issues concerning libido and the physical changes that occur with age.
Related Women's Intimate Health and Wellness Resources:
- Low on Estrogren? This condition may be a very painful reality.
- First-time buyers: an Intimate Massager guide