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Preventing Vaginal Fissures

December 25, 2010
Vaginal fissures are tears or cracks in the lining of your vagina. The lining of your vagina is very sensitive to estrogen. Before menopause, the vagina is made up of thick layers of healthy cells.Estrogen encourages the growth and development of these cells, so that the vaginal epithelium (lining) will remain thick and moist. Estrogen also improves blood flow to the genital area and keeps the walls of the vagina supple and elastic.

This happy environment stimulated by estrogen also helps protect the vagina against bacterial infection.

When estrogen levels are low, vaginal changes make it more prone to bacterial infection. The bacteria in the vagina may also reach the urethra and cause urinary tract infection.

Your outer genital areas may become dry, itchy and more easily irritated. A decrease in blood flow leads to fewer secretions and more dryness.

This is the unhappy environment where fissures can flourish. Estrogen levels can be tested with blood work.

You should also do an inventory of any medications you are taking because certain medications have anti-estrogen properties (including Tamoxifen, Danazol, Medroxyprogesterone, Leuprolide, and Nafarelin).

If low estrogen levels are not found on blood testing, it may be that the fissures are caused by injury. The most common injury is intercourse without proper lubrication.

Alternatively, recurrent yeast infections have also been found to cause injury to the vaginal lining.

The best way to prevent vaginal infection is to take good care of yourself. Be sure to eat a healthy, varied diet and maintain your proper weight.

Alleviate stress through exercise, meditation, and other tension-relieving activities. Be sure your clothing ‘breathes;’ avoid tight garments and fabrics containing a high percentage of synthetic fiber. Use condoms to prevent sexually transmitted infections.

A word about douching… your vagina is self-cleaning and douching can disturb not only this normal process, but also the balance between healthy and unhealthy bacteria, making you more prone to infection and dryness.

If you douche, think about stopping this unnecessary practice altogether.

Finally, if you smoke, here are two more reasons to quit: smoking can not only contribute to vaginal dryness, but it also delays healing so that if you are developing fissures, they will take longer to heal.

In terms of treatment, you must first begin with proper diagnosis. You should see a gynecologist to find out exactly what is causing your vaginal dryness.

Depending on your diagnosis (low estrogen, recurrent infections, decreased lubrication) the medications prescribed can include medications to treat infection (usually anti-fungals in the form of a cream, a vaginal suppository, or an oral pill), medication to boost moisture levels within the vagina (including cortisone cream), medication to improve estrogen levels (either throughout the body – with an oral hormone pill, or in the vagina only – with hormone cream), and/or lubricants with sexual intercourse and activity (Astroglide and KY are acceptable choices).

Source: Eileen McMahon, advanced practice nurse, Sunnybrook Health Sciences Centre.

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