Dyspaurenia Causes and Treatment
What is dyspareunia? Dyspareunia or discomfort during intercourse, can occur during menopause due to changes in hormone levels leading to vaginal dryness, and reduced elasticity of the vaginal walls. When occurs, occur sexual activity might be painful and unpleasant. It is essential to contact a professional to get evaluated including having a pelvic exam, blood test, and possibly imaging studies.
Potential Causes: The main cause of vaginal dryness is a decrease in the level of estrogen which usually takes place in perimenopause/menopause when the ovarian function decreases significantly. In women who underwent surgical menopause meaning following resection of the ovaries, the hormone level decreases drastically. Those women can experience vaginal dryness due to a rapid lack of hormones after surgical removal. Finally, in women after treatment with radiation or chemotherapy for various cancer diagnoses, ovarian function deteriorates leading to vaginal dryness as well.
Evaluation: Following physical examination, the doctor will obtain medical history to determine what is the cause of the condition. In addition, the doctor may obtain blood tests to find out what the etiology might be including menopausal changes, hormonal imbalance, status post-chemotherapy or radiation therapy, or surgical menopause. Once the potential cause is determined, the doctor would recommend therapy to eliminate or attenuate the symptoms.
Treatment: Dyspaurenia due to vaginal dryness can be treated with the following options:
Lubricants: They are over-the-counter water-based or silicone-based lubricants which may help reduce discomfort
Hormone therapy: It includes hormone replacement options if the symptoms are due to hormonal deficiency. Some medications such as estrogen cream, inserts, or tablets may be prescribed by the provider.
Pelvic Floor Exercises: Strengthening the pelvic floor muscles can help improve the elasticity, health, and thus function of the anatomical area.
Vaginal moisturizers: In patients where hormonal therapy is contraindicated and/or other options are ineffective, vaginal moisturizers might be of benefit.
PRP injections: In certain patients, injection with Platelet Rich Plasma might be effective as well.
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