What is vaginal stenosis?
Vaginal stenosis is defined as a narrowing of the vaginal canal. This phenomenon occurs when an attack on the tissues causes inflammation, followed by fibrosis, which makes the vagina rigid.
Main causes :
- Pelvic radiotherapy: this alters the vaginal mucosa, leading to thinning of the tissues, reduced lubrication and the formation of fibrosis.
- Pelvic surgery: certain procedures such as hysterectomy can alter the vaginal structure, although this complication is rare.
- Dermatological diseases: certain pathologies such as lichen sclerosus or lichen planus can weaken the vagina and contribute to vaginal stenosis.
- Menopause: the reduction in oestrogen makes the vaginal wall thinner and drier, aggravating the symptoms of vaginal stenosis.
Symptoms of vaginal stenosis and impact on daily life
Vaginal stenosis causes significant discomfort, affecting both intimate life and medical care. Pain during sexual intercourse, or dyspareunia, is one of the most common symptoms, particularly during penetration. Post-coital bleeding may also occur, reflecting the fragility of the affected tissues. Inserting tampons also becomes painful or even impractical.
During gynaecological examinations, the reduction in vaginal suppleness can cause a feeling of tension and discomfort, complicating medical monitoring and even making it impossible to use a speculum.
Vaginal dryness, accentuated by the loss of elasticity and sometimes by hormonal changes, aggravates sensations of irritation and discomfort. Taken together, these symptoms have an impact on quality of life and can lead to apprehension about intimate relations or medical consultations, delaying appropriate treatment.
Vaginal dilatation therapy: an effective treatment
Vaginal dilatation therapy is one of the most effective solutions for preventing and treating vaginal stenosis. Its aim is to preserve the elasticity of the vagina.
To achieve this, vaginal dilators, sex toys, penetration during intercourse or simply the fingers are gradually inserted to gently stretch the tissues. Initiation of this therapy is recommended between two and eight weeks after radiotherapy, once the acute inflammatory phase has passed. Regular use over a prolonged period helps to stabilise the acquired skills.
This therapy is best learnt under the guidance of specialised professionals such as midwives. Their expertise enables patients to acquire the right gestures, better understand how to use dilators and regain confidence in their bodies. When properly supervised, this treatment considerably improves comfort and encourages a gradual return to a more serene intimate and gynaecological life.
Treatment at Hôpital de La Tour
Midwives specialising in perineal re-education and trained in dilatation therapy will welcome you. Dilatation therapy is taught at the hospital and then continued independently at home. Appointments are made via Onedoc, for the following reason: Traitement vaginal post traitement radiologique. Consultations take place at the maternity unit, usually on Mondays.
Complementary therapies
In addition to vaginal dilatation therapy, other approaches can be considered to improve tissue flexibility and reduce discomfort:
- Perineal re-education: Exercises are used to make the pelvic floor muscles more supple and reduce the tension associated with the anticipation of pain.
- Local hormone treatment: The application of oestrogen-based creams can improve the elasticity of vaginal tissues in cases of hormonal deficiency.
- Vaginal lubricants and moisturisers: These products help to reduce dryness and daily discomfort.
- Surgery: As a last resort, surgery may be considered to widen the vaginal canal.
Conclusion: key points
Vaginal stenosis is a complication that frequently occurs following pelvic radiotherapy, but it is under-diagnosed and can affect patients' quality of life. Fortunately, there is a simple preventive method and treatments available. Vaginal dilatation therapy is the gold standard. Appropriate medical monitoring and specialist support can optimise results and help patients return to a comfortable intimate and gynaecological life.
