As we welcome the warmer weather of spring and prepare for the long, sunny days of summer, it's important for women to consider how seasonal changes can impact their health, including the management of symptoms related to vaginal atrophy or Genitourinary Syndrome of Menopause (GSM).

As women progress through pre-menopause and post-menopause, they may experience a range of symptoms related to vaginal atrophy, also known as Genitourinary Syndrome of Menopause (GSM). Studies have shown that approximately 15-45% of women experience symptoms such as vaginal dryness, itching, burning, painful intercourse, and decreased libido. In addition, some women may experience urinary symptoms like recurrent infections and urgency. In this newsletter, we will explore treatment options for GSM and discuss ways to manage symptoms to improve quality of life.

Genitourinary Syndrome of Menopause (GSM) is caused by the decrease in estrogen levels that occurs during menopause. Estrogen is a hormone that helps keep the vaginal lining healthy, thick, and moist. As estrogen levels decline, the tissues in the vagina and vulva become thinner, drier, and less elastic, leading to the symptoms associated with GSM. Other factors that may contribute to GSM include smoking, certain medical conditions or treatments, and certain medications.

The main purpose of the treatment for vaginal atrophy is to recover and stimulate pre-menopausal metabolic activity through a new synthesis of collagen, hyaluronic acid and proteoglycans. The result is a hydrated mucosa with the functions typical of younger and healthier tissue.

Non Prescription Vaginal Moisturizers

• such as Repagyn, Replens, or Gynotrof gel

• May help the feeling of dryness but do not reverse the underlying cause

Vaginal Estrogen Creams

• Premarin or Estragyn

• Used nightly for one week then twice weekly thereafter. 

• If you stop using the cream, your symptoms will recur. 

Vaginal Pills

• Vagifem

• Used nightly for two weeks then twice weekly thereafter. 

• If you stop using the pills, your symptoms will recur. 

Estring

• A silicone ring in the vagina that is replaced every three months which slowly releases low levels of estrogen into the vaginal tissues.

NEW INNOVATIVE TREATMENT - Mona Lisa Touch Laser Treatment

Non-surgical office-based CO2 laser treatment of the vulva and/or vagina 

• The treatment enhances the vaginal mucosa and restores its pre-menopausal structure. The treatment activates fibroblasts of the mucosa which promote collagen synthesis.
• This results in increased water content, increased small blood vessel formation (capillary), the better transformation of nutrients, and restoring the correct rehydration and revitalization of the vaginal mucosa.

How many treatments are required?

Laser treatments are given for two to three consecutive months and then yearly.

Can this treatment help vaginal laxity?

Yes it may assist vaginal tone and support. Mild prolapse symptoms may be improved. Moderate to severe prolapse symptoms are usually treated surgically or with pessaries.