According to a gynecologist, more than 50 percent of women suffer from at least one form of intimate dysfunction: incontinence or frequent urination, vaginal dryness leading to urinary tract infection, or vaginal laxity.
Dr. Annebelle Aherrera, aesthetic gynecologist at Makati Medical Center, observes that when there is a problem on the face, women will not hesitate to see a dermatologist. However, when they experience vaginal dryness, itching and uncontrollable urination, they would rather tolerate the symptoms instead of discussing them with a gynecologist.
Then again, mature patients come to her complaining of incontinence and burning sensations. When Dr. Aherrera tells them that there are many options to suit the different budgets, they give her a fatalistic reply that they’ve gotten used to these inconveniences. “Don’t let these attitudes prevent you from getting help,” she says.
A harmonious ecosystem
Dr. Aherrera underscores the importance of women’s health education, since vulvar and vaginal health are part of a women’s overall well-being. Comparing the female anatomy to the face, she explains: “The vulva is the external genitalia, comparable to the upper face. The vulva consists of the folds of skin around the opening of the vagina (birth canal) and urethra (the tube that drains urine from the bladder).
“The vagina is the opening found in the external genitalia (vulva), comparable to the mouth. The labia majora (larger outer folds of the vulva) is comparable to our cheeks, while the labia minora (smaller folds) is likened to the crease between the base of the nose and the cheek. Like any body part that has reached its full development, the female genitalia’s biological clock winds down and the natural aging process begins.”
To maintain vaginal health, the female hormone, estrogen, and the naturally occurring good bacteria, lactobacilli, must be present in the vagina. “They both provide a harmonious ecosystem to maintain the natural acidic pH of the vagina that is necessary to prevent unwanted intruders,” says Aherrera.
When the levels of estrogen and lactobacilli start to wane, the result is vaginal dryness, burning sensation, irritation, vaginal discharges and itchiness.
Just like in normal skin, protein fibers called collagen and elastin are important in keeping the female anatomy firm and maintaining its shape. The weakening of these protein fibers lead to sagging and dryness—in other words, an exhausted vulva. Hence, the decline of female hormones, good bacteria and protein fibers make the vulva vulnerable to stressors such as bacterial and fungal infection, leading to itching, generalized dryness or lack of vaginal moisture or wetness.“This begets the vicious cycle of vaginal dryness (less moistened by estrogen and less lubrication), painful sex (dyspareunia), decline in sexual activity and eventually low sex drive,” she explains.
Dr. Aherrera points out that signs of aging in the genitals can start as early as 35 years old.
“Before childbirth and aging, the vaginal muscles and tissues are strong and toned. The diameter of the vaginal canal is narrow. During childbirth or with continuous sexual intercourse, the vaginal wall stretches. When it expands, it doesn’t return to its original position. Hence, there is vaginal looseness. Since the bladder wall likewise becomes lax, women will start complaining of urinary frequency. These urinary complaints add to the loss of sexual intimacy from laxity in the vagina and bladder,” she says.
Vicious cycle
“As natural aging steps in, the vaginal wall starts to atrophy, that is, it becomes inflamed, loses moisture and lubrication. A vicious cycle begins,” she notes.
Dr. Aherrera adds that although there is no miracle cure for vaginal dryness, there are solutions that provide relief by moisturizing and lubricating the vagina.
In hormonal replacement, estrogen (generic name: estriol) cream is inserted in the vagina every night for the first week, then twice or thrice a week as maintenance. There is no evidence that suggests that the cream will cause breast cancer. Vaginal tablets containing estrogen and naturally occurring lactobacilli (estradiol) can be inserted.
Dietary supplements and oral probiotics can restore lost vaginal lactobacilli. Oral hormonal replacement (tibolone), another option, is a combination of progesterone, estrogen and androgen. It replaces the insufficient estrogen levels in the body while increasing libido.
Platelet-rich plasma (PRP) therapy uses a concentration of patient’s platelets to hasten the healing of whitish-gray patches outside the genitals called vulvar dystrophy and dermatoses. PRP is also used to address sexual dysfunction and urinary incontinence.
A small amount of blood is drawn from one’s vein and collected in specialized kits, processed to separate the plasma from the platelets. This precipitate, an insoluble solid that emerges from a liquid solution, will then be injected in the area of concern. Since the collected blood is yours, the risks of infection and infections are minimal.
PRP activates young stem cells that rejuvenate impaired tissues. It promotes overall tissue health, increases natural lubrication, improves sexual drive, reduces urinary incontinence and relieves vulva itching, pain or discomfort.
Energy-based devices are used for what is called nonsurgical vaginal rejuvenation. One of the most popular is the radiofrequency temperature-controlled procedure, which uses the science of heat massage over the weakened genital tissues.
“It is not a laser,” says Dr. Aherrera. “It works to stimulate the production of collagen and elastin fibers. This modality is only an alternative solution to the bare basic treatment for lack of estrogen and insufficient lactobacilli of the aging vulvovaginal area. A single treatment improves urinary control, sexual health and function, increases libido, and provides vaginal rejuvenation.” —CONTRIBUTED INQ