Over the years, our body changes and this is widely accepted and known. What is not so important is that the vulva and vagina also undergo changes, the lower lips protrude and some alterations occur.
First of all, we must know that the vulva is lined with skin and the vagina with mucosa, so the changes will be very different. In both cases, hormones exert an important influence over the years.
The vagina in childhood and adolescence
The vaginal mucosa during childhood does not have estrogenic influence, that is, of the female hormones produced in the ovaries, estrogens. It is a thin and poorly lubricated mucosa , without flow and its pH is basic. With adolescence, estrogens begin to be produced in the ovaries that will cause changes in the vaginal mucosa. Estrogens will stimulate an increase in the thickness of the mucosa , accompanied by a greater blood supply that will increase lubrication .
The thickest mucosa accumulates glucose , which will serve as food for the bacteria that will colonize it, the vaginal microbiota . This microbiota is basically made up of lactobacilli, which produce lactic acid and will lower the pH of the vagina to acid. These changes lead to a more elastic, pink and lubricated vagina . Part of the flow also occurs in the cervix and descends through the vagina.
In menopause
In menopause , estrogen production decreases and, therefore, the vaginal mucosa loses elasticity as collagen decreases. Blood flow decreases , so does lubrication , causing the mucosa to become thin and friable (with a tendency to crumble).
As a consequence of these changes , sexual intercourse becomes painful , atrophy and dryness produce frequent itching and changes in the vaginal microbiota favor the appearance of infections , both vaginal and urine.
During postpartum
Estrogen production is also decreased by the inhibition of the functioning of the ovaries and, therefore, changes similar to those of menopause occur , with more painful sexual intercourse due to the lack of lubrication and the lack of flow that can occur. place to vulvar itching. Taking contraceptives also decreases the production of estrogen in the ovaries by inhibiting their operation and therefore can cause vaginal dryness, which recovers when treatment is stopped.
The vulva: change of appearance
Over the years, there is also a change in the appearance of the vulva. It is a generalized process, but it can vary in each woman in the same way that the passage of time in the rest of the body has a different influence on each one.
In youth, the labia majora cover the minor labia and the tissues are toned. Over time the tissue darkens, loses smoothness and the labia minora protrude more . The subcutaneous fat also decreases and, therefore, the labia minora lose volume. The mount of venus or pubis also undergoes changes by reducing subcutaneous fat and presents more flaccidity.
Counter the changes
To counteract these changes there are some treatments. In menopause, or in periods with low vaginal lubrication, vaginal lubricants can be used during sexual intercourse or vaginal and vulvar moisturizers to reduce dryness that causes itching.
If this is not enough, drugs with estrogens can be administered that increase the amount of estrogen in the vagina and, therefore, increase the thickness of the vaginal mucosa, giving it more resistance and elasticity . They also increase the production of vaginal discharge and, consequently, reduce dyspareunia, pain with intercourse, and produce changes in the vaginal microbiota in a way that protects against urinary and vaginal infection.
These estrogens can be administered locally, in vaginal cream , vaginal tablet or suppositories and can also be administered systemically, throughout the body, in these cases being the route of administration in oral tablets or in patches.
Systemic treatments, in addition to a vaginal effect, have an effect on bothersome hot flashes, protection at the bone level…
Aesthetic treatments?
The vagina and vulvar area can also undergo aesthetic treatments to improve their appearance .
An infiltration of hyaluronic acid can be performed at the entrance of the vagina and the vulvar fork. This hyaluronic acid retains water and therefore provides more hydration to the skin and mucosa. This treatment usually lasts about a year and then has to be repeated to obtain the expected results.
Hyaluronic acid can also be used for the aesthetic filling of the labia majora . By losing part of their fat and, therefore, their volume, the labia majora have a more flaccid appearance and by filling them with hyaluronic acid they recover smoothness and better cover the labia minora. It is also possible to perform a lip filler with fat infiltrations of the same patient.
In addition, surgical treatments can be performed, such as labiaplasty , which consists of reducing the size of the labia minora, or a lifting of the labia majora and pubis.
Laser and radiofrequency are currently being used in the treatment of vaginal atrophy and discomfort, especially in menopause, but more studies have yet to be published to support their results.
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