阴道萎缩如何被诊断出来？

First, it’s helpful to see if you’re at risk for VA. It affects around half of all menopausal people (typical age: 51) because of the natural drop in estrogen that happens then, but it can also happen during perimenopause, the transition period (no pun intended) before menopause—which can happen anytime in adulthood! Other reasons for estrogen loss leading to VA include having little body fat (fat cells produce estrogen), says Shari Lawson, M.D., division director of general obstetrics and gynecology at Johns Hopkins Bayview Medical Center in Baltimore, and having your ovaries removed or taking certain medications.

Maybe you use lubricants but still have pain during sex. Maybe it burns or hurts when you pee. Maybe your nether regions are so dry, itchy, and/or burning, you’re in agony, especially if you sit for long stretches of time (work-from-home, anyone?). These are all possible VA symptoms. If you have recurrent urinary tract infections (UTIs), this may indicate VA too because the same drop in estrogen linked to VA raises your UTI risk, says Amy Park, M.D., section head of female pelvic medicine and reconstructive surgery at Cleveland Clinic in Cleveland, OH.

So you’re in the at-risk group for VA and/or you’re experiencing symptoms. Now what? Make an appointment with your obstetrician-gynecologist (OB-GYN). People usually see their OB-GYN for VA when their symptoms really impact their quality of life, Dr. Park says—but you don’t have to wait. VA can affect sexual intimacy and self-esteem, wreaking havoc on your romantic relationship and your general enjoyment of life, she says. Confirming you have VA can give you not only peace of mind, but also access to treatment that can help slow VA’s progression.

You go to your OB-GYN and tell them what you’re experiencing. What comes next? Doctors typically make a VA diagnosis based on these things:

• Medical history
• Symptoms
• 体检

让我们谈谈每个深度。

询问您的病史是达到诊断的标准做法，并在VA中，通常没有任何不同。您的医疗保健专业人员可能会询问：Your complete medical history（您拥有或拥有的任何疾病和疾病）;过去的外科历史（你有什么侵入性程序，何时何地）;家庭病史（你对疾病的遗传倾向）;社会历史（包括你吸烟，喝酒，运动 - 你的性活动/习惯是什么？）;Allergies(are you allergic to any medication or food?);药物(those you’re taking or may have recently stopped taking).

劳森博士说，接下来，您的医生通常会提出有关症状的问题。当你体验到它们时，这些症状开始时可以包括，以及你在家尝试帮助的时候。“有时症状与物理结果不相关，因为有些女性没有性活跃，所以他们不知道他们是否有阴道干，”帕德博士说。“他们可能有更多的泌尿情况或反复性UTI，而有性活跃的人会有更多的阴道干燥投诉。因此，做历史和体检是很重要的。“

最后，您的医生可能会进行阴道考试。帕克博士说，他们需要看到阴道组织的外观。“当我们看看组织时，我们可以看出他们是否已经开始萎缩，”劳森博士解释道。“这基本上意味着由于雌激素的丧失，他们不会像以前那样丰满。”在VA的前辈妇女中，阴道衬里看起来黄色而不是其通常的粉红色。她说，由于前进的女性在阴道内有一点皱纹，因为那个群体中的va的另一个迹象是一个平滑的阴道。

“雌激素对阴道有很大的影响，”公园博士，如加厚阴道组织，并保持它们润滑。对于VA，组织可能是薄，脆弱的，甚至在体检期间甚至出血。其他迹象：小红点称为Petechiae和阴道的一些缩短。Lawson博士说，VA的另一个迹象是当你的医生发现它难以做到生理学考试时（当他们将两个手指插入阴道时）。发生这种情况是因为阴道开口从缺乏雌激素丢失弹性，使其就像一个紧绷的带。

根据您的症状，Lawson博士说，您的医生可能会检查，以确保您没有像细菌性阴道病（BV）或酵母菌感染等阴道感染。这可能涉及Park博士叫“湿式准备”或阴道涂抹的细胞。如果你有痛苦或燃烧的排尿，劳森博士说，你的医生可能想做尿文化来检查UTI。“在大多数情况下，一旦你排除感染并且你已经完成了体检，你可以说这可能是阴道萎缩，”她说。

弗吉尼亚州的一线疗法是水或石油based lubricants for sexual activity (even coconut oil works, says Dr. Lawson) and vaginal moisturizers, all available at your local drugstore. Or using dilator might help loosen vaginal tightness. Or your doctor could prescribe vaginal estrogen. It’s low dose and “hardly has any systemic absorption into the bloodstream,” Dr. Park says. Side effects are typically mild, like hot flashes and in more serious cases, blood clots. “Overall, patients tend to benefit quite a bit from using a small amount of vaginal estrogen,” she says.