Vaginal atrophy, stemming from declining estrogen levels, is a condition that affects women. Estrogen fluctuations can arise from menopause, cancer, and cancer treatments, leading to changes in the vaginal wall, such as inflammation, thinning, and dryness. 

Given estrogen's crucial role in sustaining vaginal health, its decline can cause a loss of elasticity and flexibility in vaginal tissues. As a result, women may encounter discomforting symptoms like itching, burning, painful intercourse, and urinary issues. 

The presence of cancer can indirectly contribute to the onset of vaginal atrophy. Specific cancer types like breast, ovarian, or uterine may necessitate treatments that disturb the natural estrogen balance within the body. These treatments can include: 

• Chemotherapy — certain types of chemotherapy drugs can cause changes to the ovaries which can affect estrogen production 

• Hormonal Therapy — such as aromatase inhibitors or GnRH agonists 

• Radiation Therapy — when directed to the pelvic region, it can cause damage to the blood vessels and decrease blood flow to vaginal tissue

• Surgical Interventions — such as the removal of the ovaries or uterus 

The reduced estrogen production caused by these treatments can ultimately lead to vaginal atrophy.

Suppose you are experiencing any symptoms of vaginal atrophy, such as vaginal dryness, burning, pain, recurrent UTIs, etc. In that case, it is crucial to reach out to your doctor to talk about treatment options for improving your quality of life. Some of the more common treatment options include: 

• Vaginal moisturizers and lubricants — These can be obtained over the counter and can provide temporary relief by increasing moisture during sexual activity. 

• Topical estrogen ointments — These can be prescribed by your provider in certain circumstances. 

• Vaginal dilators — These can be obtained over the counter and can help stretch the vaginal muscles. 

• Pelvic floor therapy — Exercises such as Kegels can help strengthen vaginal muscles and enhance vaginal tone. 

Understanding the causes and treatment options for this condition is essential for effective management and to improve your overall well-being. Questions to ask your doctor can include: 

• Would a referral to a pelvic health therapist be helpful? 

• What treatment options do you recommend? 

• How can I best manage these symptoms with my history of cancer?