Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  K. Michael 12 October 2015

  The case study indicates that the skin in the vaginal area tears easily. Is that due to the the skin actually thinning ?

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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    Michelle Kaarto, BScK, CSEP CEP 16 November 2015

    @K.Michael - in vaginal atrophy, the vaginal walls become dry, inflamed, and thinner so this would explain the tearing because it actually is thinner.

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  Dr. Sharon Gurm BSc, ND, FABNO (Naturopathic Oncologist) Naturopathic Doctor, Port Moody, BC 07 May 2015 Port Moody Health- Integrative Medicine& Cancer Care

  Vaginal atrophy is a common complaint for menopausal women ranging from mild to severe. This particular case is what I would call moderate-to-severe vaginal atrophy. Genital tissue is hormone-sensitive. The external genitalia and vaginal mucosa typically change (become atrophic) as estrogen levels decline. Some women experience more severe vaginal atrophy than others. The itch and recurrent urinary tract infections are often not an independent condition in these situations, but rather they are a result of the tissue changes caused by a deficiency in local estrogen levels. If she is not experiencing other significant symptoms of menopause, a trial of topical and/or intravaginal low-dose estradiol and estriol combination cream is a better treatment choice than oral estrogen. The estrogen cream often solves the issue of dryness, itch and fragile tissue contributing to frequent urinary tract infections. If the woman is not a candidate for hormone therapy, a compounded vaginal suppository of vitamin E, vitamin A and calendula cream would help restore tissue integrity. Lubricants will only mask the problem and do not address the external genital atrophy and may actually increase the likelihood of urinary tract infections.

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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    Dr. Sharon Gurm BSc, ND, FABNO (Naturopathic Oncologist) Naturopathic Doctor, Port Moody, BC 12 September 2015 Port Moody Health- Integrative Medicine& Cancer Care

    In my opinion, transdermal hormone therapies, intra-vaginal hormone-based creams and suppositories should be compounded to provide a personalized, low-dose estrogen therapy. Although standardized forms are available, such as Vagifem (an intra-vaginal tablet), the amount of estrogen delivered by standard forms is often far greater than what the patient requires to treat her symptoms and resolve the issues. As a general rule with hormone therapies, it's advisable to start with the lowest effective dose.

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    K. Michael 12 September 2015

    Are the hormone based creams and suppositories individualized ? Or are they standard dosages like contraceptive hormone therapy ?

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    Dr. Sharon Gurm BSc, ND, FABNO (Naturopathic Oncologist) Naturopathic Doctor, Port Moody, BC 17 August 2015 Port Moody Health- Integrative Medicine& Cancer Care

    Hormone-based creams, gels and suppositories all require a prescription from a naturopathic physician or medical doctor.

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    K. Michael 17 August 2015

    Would the vaginal suppository you recommend be a prescription item or available over the counter ?

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  Joy 04 May 2015

  Perhaps the creams and lubricants she has been using are contributing to her skin irritation. Is there something she can take orally to relieve her vaginal dryness and itchiness? Would a probiotic help with her recurring urinary infections?

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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    Dr. Sharon Gurm BSc, ND, FABNO (Naturopathic Oncologist) Naturopathic Doctor, Port Moody, BC 03 August 2015 Port Moody Health- Integrative Medicine& Cancer Care

    Oral probiotics can certainly aid in re-establishing healthy flora in several mucosal regions of the body - such as the stomach, intestine and urogenital regions - thereby preventing recurring or secondary infections that may occur after one or more courses of antibiotics or anti-fungals. In a case of mild vaginal irritation and atrophy, oral probiotics as a stand-alone treatment may suffice. Since this case is moderate-to-severe vaginal atrophy and irritation, it is unlikely that oral probiotics alone will resolve the issue. However, probiotics should be part of the overall treatment strategy. Locally applied vaginal estrogen creams compounded using a hypoallergenic base, is unlikely to cause further irritation.

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    K. Michael 03 August 2015

    I was wondering the same thing. Could her frequent use of yeast infection creams have contributed to the condition ?

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  Dr. Vivien Brown MD,CM, CCFP, FCFP, NCMP Family Doctor, Toronto, ON 27 April 2015

  Early in the phase of atrophy or dryness, in the area, lots of women may choose to go to the pharmacy and use something simple, like a lubricant, which is something you would use when you're sexually active, or a moisturizer, which is something you would use three or four times a week, whether or not you're sexually active.

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  Bernadette van der Boom-Bebb 04 February 2015

  This article emphasizes the importance of pharmacists in our medical care. All too often people will seek information from someone other than their physician as a result of the sensitive nature of the topic.

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  ShirleyG 27 January 2015

  When women are experiencing reoccurring urinary infections, vaginal dryness and itchiness is this something they should be speaking to a pharmacist about ? When do you need to speak to a doctor and escalate the issue ?

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  Yuan Lew, MSc MBA 10 December 2014

  I went to a seminar today and learnt that vaginal dryness can also occur in women who underwent radio or chemotherapy for cancer.

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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    Joy 06 April 2015

    I would think menopause plays a role in Karen's case.

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  K. Michael 10 December 2014

  I think women in general are reluctant to see a doctor for vaginal issues. It's easier to pick up something over the counter but in many cases we are only creating additional problems by not getting properly diagnosed

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  K. Michael 07 December 2014

  Is this a condition that hormone therapy would help with ?

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  Yuan Lew, MSc MBA 01 December 2014

  What course of treatment will be recommended? Is vaginal atrophy reversible with the appropriate treatment?

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"

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  K. Michael 30 November 2014

  Vaginal dryness is something that all women can occur at some point in life. There are a lot of lubricants out there to help

  Reply to: Treatment of Vaginal Atrophy " Karen a 60-year-old woman with recurrent urinary infections, vaginal dryness and itch"