Atrophic Vaginitis

The drop in estrogen that comes with menopause or even during breastfeeding after delivery causes physical and emotional changes that may have a significant impact on comfort and quality of life. Among the most bothersome problems is atrophic vaginitis, which is the lack of nourishment and hydration of the cells of the vaginal mucosa. This condition causes a progressive thinning of the vaginal and vulvar mucosa which then becomes more delicate, sensitive and more exposed to trauma.

Vaginal dryness and irritation may be a result of atrophic vaginitis, which is often not discussed because some consider it a natural consequence of menopause and postpartum. Thanks to innovative laser techniques, this problem can now be treated in a safe and painless way.

What is vaginal and vulvar atrophy?

Atrophy is a condition in which the walls of the vagina and vulva become thinner and dryer due to a decrease in estrogen. It affects around 40 percent of women, particularly after menopause, and can cause painful intercourse, vaginal dryness, burning and decreased urinary tract health resulting in pain with urinary frequency and even recurrent urinary tract infections.

What treatments are available for vaginal atrophy?

Until recently, traditional therapies for vaginal atrophy included hormonal treatment such as estrogen, an oral medication called Osphena, and a variety of vaginal moisturizers and/or lubricants. Many women are unwilling or unable to take hormones either because they are breast or uterine cancer survivors or because they have tried hormone therapy without success.

Fortunately, there is a new non-hormonal treatment that has improved on traditional laser therapy, called MorpheusV (radiofrequency with microneedling) that has been shown to be very effective in treating this problem.

What is the MorpheusV Therapy?

MorpheusV is a minimally-invasive treatment designed to improve the health and pliability of the vaginal mucosa (inner lining of the vagina). A specially designed microneedling device using radiofrequency is used in an office setting to treat an atrophic or thin and sensitive vaginal wall. Using this technique, it is possible to deliver radiofrequency energy deep into the layers of the vaginal wall in a manner that stimulates collagen and returns the vaginal tissue to the condition present prior to the changes induced by menopause or other causes. Although lasers have been previously used for this application, the advantage of using a radiofrequency delivered via microneedling allows for deeper penetration into the tissue without the complicating factors arising from use of lasers.  No eye protection is needed, and deeper penetration into the tissue promotes a more robust collagen and vascular (support tissue and blood flow) response.

How successful is the therapy?

Studies in the US and worldwise have demonstrated a significant improvement in the symptoms beginning as soon as a few weeks following the first treatment.

How many treatments are necessary?

The recommended treatment program is three treatments, each four weeks apart. This usually allows a significant or complete relief of symptoms for approximately up to one year, after which another treatment session is usually required.

Is the treatment painful?

Because of the depth of penetration, topical anesthesia is typically placed for several minutes prior to the procedure. For some women, additional nitrous oxide inhalation during the procedure is helpful if they note more than minimal discomfort. The procedure is done in a simple manner by placing a small probe in the vagina (see illustration) with minimal discomfort. The treatment session lasts approximately five minutes, and no post treatment pain medication is required.

Are there any post-treatment restrictions?

As mentioned, most women have minimal to no pain with the therapy, however, a few women may note some slight localized discomfort. Mild vaginal spotting or bleeding may sometimes occur for a short time after the procedure.  Full activity is usually resumed within 24 to 48 hours.  It is recommended to avoid vaginal penetration for 72 hours following the procedure.

Are there any side effects or complications?

If there is any history of genital herpes, it is recommended to take prophylactic (preventive) valacyclovir or acyclovir as treatment may sometimes initiate an outbreak.  Anyone with significant pelvic muscle spasm may find this more uncomfortable as muscles may contract during the procedure.  Dr. Kiley will check for that prior to treatment and will indicate whether this is likely to occur.