Vulvovaginal Atrophy, Genital Menopause Syndrome: Causes

Pathogenesis (disease development)

The cause is estrogen deficiency. Estrogen receptors are reduced, atrophy occurs, and loss of function of the external genitalia, vagina, bladder, urethra, and pelvic floor develops; urogenital menopause syndrome develops.

  • Most pronounced and regular, these changes occur during the climacteric/menopause (the time of the last menstrual period).
  • Less pronounced in the puerperium
  • Moderate in hormonal imbalance and cycle disturbances
  • Occasionally when taking ovulation inhibitors/antibaby pill

Specifically:

  • Vagina (vagina) → atrophic colpitis (vaginitis), colpitis senilis (dry vagina):
    • Epithelium: breakdown of the epithelium, which consists of only a few cell layers and no longer forms glycogen.
    • Lamina propria (layer of connective tissue found under epithelia):
      • Loss of
        • Formation of elastic and collagen fibers.
        • Ability to form tissue fluid
        • Supplying capillaries
    • Musculature:
      • Reduction of the musculature
      • Abolition of the vaginal folds (Rugae vaginales).
  • Sheath wall:
    • It is pale, thin, as if transparent, reddened, dry, inelastic, vulnerable, often with petechiae.
  • Vulva (set of external primary sexual organs) → atrophic vulvitis (inflammation of the external female genital area and vaginal entrance):
  • Bladder → atrophic cystitis (cystitis):
  • Urethral → atrophic urethritis (inflammation of the urethra):
    • Regression
      • Of the mucosa (mucous membrane)
        • Reduction of tissue fluid
        • Of elasticity
        • Of the capillary supply
        • Of the venous plexus
    • Regression of the musculature
    • Reduction of anatomical and functional lengthConsequence: favoring ascending infections, insufficiency of urethral closure pressure, reduction of urethral closure pressure.
  • Pelvic floor:

Etiology (causes)

Biographical causes

  • Genetic diseases
    • Turner syndrome (synonyms: Ullrich-Turner syndrome, UTS) – genetic disorder that usually occurs sporadically; girls/women with this disorder have only one functional X chromosome instead of the usual two (monosomy X); et al. Among other things, with an anomaly of the aortic valve (33% of these patients have an aneurysm/diseased bulging of an artery); it is the only viable monosomy in humans and occurs approximately once in 2,500 female newborns.
  • Age of life – climacteric, postmenopause (period that begins when menstruation has ceased for at least a year), senium (old age).
  • Hormonal factors – estrogen deficiency situations.

Behavioral causes

Consumption of stimulants

Medication

  • Ovulation inhibitors (birth control pills)

Operations

  • Ovarectomy (removal of the ovaries)

X-rays

Medication