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9 Signs of Low Estrogen that Affect Your Vaginal and Urinary Health

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Vaginal Dryness | Vaginal Itching or Burning | Vaginal Discharge | Painful Sexual Intercourse | Urinary Symptoms | Urinary Incontinence | Urinary Tract Infections | Genital Atrophy | Risk Factors | How to Get Help

When estrogen levels decline in menopause, there’s a good chance you’ll be dealing with vaginal atrophy (VA). Vaginal atrophy is also known as the genitourinary syndrome of menopause (GSM), and refers to a constellation of vaginal and urinary symptoms caused by a lack of estrogen.

“Genitourinary syndrome of menopause is very common. It affects 50-80% of women post-menopause. And the symptoms can start prior to the stop of your periods, in the perimenopause years.”
- Dr. Kelly Casperson

Although vaginal and urinary changes are very common in menopause, few women get the care they need.(1) Remember that many vaginal conditions have similar symptoms, so it’s essential to understand if a lack of estrogen is causing your symptoms. Otherwise, you could be treating the wrong thing.

To help you assess whether you may be experiencing vaginal atrophy, we've created a checklist of common symptoms. Simply go through the checklist below and check any symptoms that apply to you.

1. Vaginal Dryness:

  • Do you experience dryness in the vaginal area?
  • Does the dryness cause discomfort or pain during sexual intercourse?
  • Do you notice a lack of natural lubrication during sexual activity?

2. Vaginal Itching or Burning:

  • Do you frequently experience itching or burning sensations in the vaginal area?
  • Does the itching or burning worsen during sexual intercourse or urination?
  • Have you noticed redness or inflammation in the vaginal area?

3. Vaginal Discharge:

  • Have you observed changes in your vaginal discharge?
  • Is the discharge thin, watery, or frothy?
  • Does the discharge have an unusual odor?

4. Painful Sexual Intercourse (Dyspareunia):

  • Do you experience pain or discomfort during or after sexual intercourse?
  • Does the pain persist despite using lubricants or taking precautions?

5. Urinary Symptoms:

  • Do you frequently experience urgency (a sudden, strong urge to urinate)?
  • Do you have to wake up frequently during the night to urinate (nocturia)?
  • Have you noticed an increase in urinary tract infections?

6. Urinary Incontinence:

  • Do you experience involuntary leakage of urine, especially when coughing, sneezing, or laughing (stress urinary incontinence)?
  • Do you have difficulty controlling your urge to urinate (urge urinary incontinence)?
  • Have you noticed a decrease in bladder control?

7. Urinary Tract Infections:

  • Have you experienced recurrent urinary tract infections?
  • Do you have symptoms such as burning sensation during urination or frequent urination associated with an infection?

8. Genital Atrophy:

  • Have you noticed thinning or shrinking of the genital tissues?
  • Does the vulvar or vaginal area appear pale, dry, or easily irritated?
  • Have you experienced a loss of elasticity or a decrease in sensation during sexual activity?

9. Risk factors for lack of estrogen

  • Are you post-menopause?
  • Are you in perimenopause?
  • Are you breastfeeding?
  • Are you taking a birth control pill?
  • Have had chemotherapy or breast cancer treatment?
  • Have you had both ovaries removed?
  • Have you recently taken or stopped taking antidepressants?

If you've checked "yes" to two or more of these questions, we encourage you to reach out to a healthcare professional, such as a gynecologist or a menopause specialist, for further evaluation for vaginal atrophy.

Fortunately, there are several simple and effective options that can help treat the root cause of vaginal atrophy. Vaginal estrogen is prescribed as a vaginal ring, cream, or suppository. Home remedies like coconut oil may also help with symptoms related to dryness.

“I like to think of vaginal estrogen as preventative care, like flossing, sunscreen and seatbelts.”
- Dr. Kelly Casperson

Vaginal atrophy can worsen with time, so early diagnosis and proper management of vaginal atrophy can significantly improve your symptoms and overall well-being!

Get care for vaginal atrophy with Interlude

Remember, this checklist is only a way to learn what vaginal atrophy looks like and should not replace personalized medical advice. By seeking medical assistance, you'll receive tailored guidance, treatment options, and ongoing support based on your specific needs.

Interlude is a 100% online telemedicine service that offers an easy online consultation, prescription treatment, and ongoing support for vaginal atrophy.

For eligible women, our caring MDs and GYNs offer prescription vaginal estradiol, 1:1 messaging, and discreet shipping to your door.