Urogenital atrophy reduces the the size and function of various reproductive organs, including the uterus, ovaries, vaginal canal and vulva. Endometrial atrophy is a component of the natural progression toward menopause. During this process, the entire vaginal wall experiences degeneration, including the collagen, elastin and smooth muscle components. Additionally, the vaginal epithelium undergoes cellular loss and thinning.

As a result of these changes, vaginal blood flow diminishes, leading to decreased lubrication during sexual arousal and heightened susceptibility to trauma and pain. Furthermore, there’s a decline in the population of lactobacilli, while the vaginal pH increases, creating a more favourable environment for pathogenic bacteria colonization. The vaginal canal undergoes alterations such as narrowing, disappearance of vaginal cul-de-sacs and fading of vaginal crests. These transformations are primarily attributed to the decline in estrogen levels associated with menopause.

- Stop smoking. moking accelerates estrogen metabolism and is associated with increased rates of osteoporosis and vaginal atrophy.

- Regular sexual activity is encourage to help maintain vaginal health. It provides a degree of protection against urogenital atrophy, likely attributed to increased blood flow to the pelvic organs. Research has also shown that masturbation leads to increased genital blood flow in postmenopausal women, potentially contributing to the preservation of female sexual health.

Vaginal moisturizer
Replens, the only vaginal moisturizer available in Canada, has been shown to be just as effective as vaginal hormone replacement therapy. Studies indicate positive alterations in the index of maturation of the vaginal epithelium, alongside increased hydration and vaginal secretions. Moreover, Replens has exhibited equivalent improvements in alleviating vaginal itching, irritation and dyspareunia when compared to vaginal hormone replacement therapy.

Vaginal lubricants
Several lubricants are available in Canada. None of these products have long-term therapeutic effects.

General replacement hormone therapy
General hormonal therapy is recommended for women experiencing symptoms associated with menopausal estrogen deficiency, such as hot flashes, sleep disturbances and vaginal atrophy.

Local vaginal hormone therapy
- Estrogen cream - Estradiol intravaginal ring - Vaginal estradiol tablets

These forms of vaginal hormone therapy have been proven to reverse vulvovaginal atrophy and relieve the symptoms of it.

The Erbium-Yag laser treatment has gained significant popularity, particularly in Europe, due to its precise therapeutic capabilities. This procedure utilizes the Erbium-Yag 2,940 nm laser to deliver a controlled circumferential photothermal treatment to the entire lining of the vaginal canal wall. By stimulating collagen production and enhancing vascularization of the vaginal mucosa, the laser naturally restores the physiological state of the vaginal wall.