Itching. Irritation. Painful intercourse. These symptoms are all too common for post-menopausal women! The decrease in estrogen levels during menopause is a major contributor to these symptoms. Many women are unaware of the many beneficial effects estrogen has on the vagina. So, let’s discuss.
Estrogen and Vaginal Health
Estrogen helps keep the vaginal environment healthy by increasing glycogen (sugar), which supports the growth of healthy bacteria in the vaginal microbiome, most notably, lactobacillus. Lactobacillus keeps the pH of the vagina low, which prevents harmful bacteria from growing. Thus, with a decrease in lactobacillus after menopause, women are at increased risk of vaginal infections. Fortunately, estrogen replacement therapy can directly influence the level of lactobacillus in the vaginal microbiome, thus decreasing the risk of vaginal infections. Additionally, estrogen influences the microbiome in the bladder. Yes. You heard correctly. Estrogen can influence the bacteria in the bladder. (FYI, the vagina and bladder are part of the larger “urogenital system”, which is named because the two systems are closely associated when developing in mother’s uterus.) Post-menopausal women with recurrent urinary tract infections show decreased rates in infections with estrogen replacement therapy.
The epithelium is the thin, outer, protective layer in the vagina. Estrogen helps to grow and mature the vaginal epithelial cells and increase their glycogen production, thus supporting the overall health of the vaginal tissue. Lactobacillus species (again, supported by estrogen) are also anti-inflammatory for the vaginal mucosal epithelial barrier. With a loss (“atrophy” is the medical term) of the epithelial barrier in the vagina, women can experience irritation, itching, dryness, painful intercourse, and even tearing of the tissue. This is one of the most noticeable menopausal symptoms for couples, as the discomfort can be significant enough to inhibit intercourse.
The good news is that these symptoms can be improved! Estrogen replacement therapy, both systemic and local, can provide significant relief of urogenital symptoms of menopause.
If you are experiencing any of the above-mentioned symptoms, don’t suffer! Call TCIM for a consultation to discuss your health concerns. Twin Cities Integrative Medicine in Maple Grove, Minnesota provides integrative health solutions to patients looking to optimize health.