Urogenital atrophy in postmenopausal women

Urogenital atrophy is one of the consequences, although perhaps less known, of women entering the menopausal stage. Despite not being as well known as hot flashes or mood swings, urogenital atrophy has many repercussions that directly affect the quality of life of these women.

Life expectancy in recent years has increased in a considerable way and, with it, the years with which the woman remains with the menopause. The decline in estrogen that occurs in this stage of life leads to several pathologies. It is estimated that at 5 years of menopause up to a third of women suffer some degree of urogenital atrophy.

Functions of estrogen in women

Estrogens are steroid sex hormones, mainly female, that they occur in the ovaries and in the adrenal glands. They are responsible for the development of female secondary sexual characteristics. Among them we find.

  • Growth and development of the breasts.
  • Regulation of menstruation with other hormones.
  • Widening of the hips.

The period of puberty and sexual maturity in women begins when the production of estrogen rises. Due, the maturation of the uterus, vagina, endometrium and fallopian tubes is stimulated.

The level of these hormones remains more or less stable until the arrival of menopause, where there is a drastic fall in these hormones. In addition to controlling the development of female secondary characters, They also have other functions such as:

  • Improve the appearance of the skin: they have an important role in the production of collagen and in the processes of skin regeneration.
  • Strengthens the functioning of the cardiovascular system: participates in the metabolism of fat and activates the production of HDL.
  • Strengthens the bone system: Estrogens prevent the loss of calcium and ensure its proper mineralization, which prevents bones from becoming fragile.
  • Contribute to the proper functioning of the urinary system: helps maintain the frequency of urinary function.
  • Acts positively on the brain: they favor the arrival of blood flow to the brain and glucose.
  • Stimulate sexual desire.

What are the symptoms of urogenital atrophy?

Symptoms of urogenital atrophy often affect patients emotionally and affect, as we have said, the quality of life. Unlike other symptoms of menopause, urogenital atrophy persists over time and can be aggravated if not treated properly.

The fall of estrogen during menopause, which are the female sex hormones, has a major impact on vaginal health. There are changes in vaginal pH that favor both vaginal and urinary infections.

Decreases the network of vessels that nourishes the vaginal mucosa and, as a result, lubrication decreases. This lack of lubrication explains the frequent irritation, dryness and dyspareunia of these women, these being the main symptoms. Dyspareunia is defined as idle when having sex.

Finally, the vaginal mucosa becomes thin and friable with an increased risk of injuries before minimal traumas such as the placement of the speculum in the consultation or intercourse.


There are several very effective treatments which can help to slow, diminish or even improve symptoms related to urogenital atrophy.

First There are the vaginal moisturizers. These, helped by lubricants during sexual intercourse, are the first line of treatment for patients who have mild or moderate symptoms. These preparations manage to reduce the symptoms of dryness and restore the pH, but they do not manage to revert the changes in the mucous membranes.

On the other hand, are hormonal treatments. This line of treatment is considered of choice for those women who present a moderate to intense clinical picture.

Hormonal preparations they manage to reverse the changes introduced by the hormonal deficit during menopause. The administration can be systemic, oral or vaginal. Low doses of estrogen administered locally are the first-choice hormone pharmacological treatment.

Finally, changes in lifestyle and non-hormonal treatment are considered the first line of the symptoms of urogenital atrophy, especially in women with minimal changes or mild symptoms. And, of course, in those women who do not want or can not use estrogen.