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Word from the expert: Dr. Fiammetta Trallo – Intimate sexual disorders

Fiammetta Trallo ESP I
Sooner or later comes the menopause… and intimate sexual disorders

Menopause is a natural event and sooner or later we all have to face it.
The cause is a decrease in the production of oestrogen hormones by the ovaries. In some women it is more pronounced, in others less, which is why we do not all have the same symptoms or have them to a greater or lesser extent.
What is certain is that we feel a change in our whole body. The most conspicuous phenomenon is the cessation of menstruation, but from the genital apparatus to the blood vessels, from the brain to the bladder, to the muscles, bones and skin, our physique is affected by this mutation.
If menopause-related osteoporosis is much talked about and prevention becomes a fundamental weapon, to alleviate the annoying hot flashes, especially at night, there are many effective products, including natural ones, little is said about changes that emerge in a more subtle way and that tend not only to persist but also to worsen: sexual intimacy disorders.

Foto Intervista Dottoressa Fiametta Trallo_2

We talk about it with Dr. Fiammetta Trallo, specialist in gynaecology and obstetrics


How do women deal with intimate disorders?

Intimate and sexual disorders are widespread among women, especially in pre- and post-menopause, but also in post-partum and after cancer therapies. Very few women, however, recognise the symptoms and consult a specialist to find a solution. Very often they do not even talk about it with friends or sisters because they confide very little about these intimate topics. And this is not good. They often find it difficult to talk about it even with their gynaecologist.

In my personal experience I also prefer to investigate with direct questions before even starting the examination on the gynaecological couch. In this way, I try to put my patients at ease by being available to listen not only to gynaecological problems but also to those related to the sexual sphere. When the hormone deficiency of the menopause alters sexual function, the discomfort is primarily psychological with repercussions on the quality of the couple’s relational life.

What are vulvo-vaginal disorders due to hormone deficiency?

Formerly referred to as vulvo-vaginal atrophy, today it is more correctly called uro-genital syndrome, because the bladder and vagina are in close contact and their wellbeing is mediated by oestrogen hormones, which are lacking or significantly reduced during menopause.

Hormone deficiency reduces the production of collagen throughout the body, a valuable substance that controls the elasticity of the body’s tissues. The effects “can be seen on the face and felt in the most intimate parts”. The vulvo-vaginal mucosa thins and both lubrication and elasticity are reduced. And from there, symptoms such as burning, itching and dryness can become a more or less constant intimate discomfort that generates pain during intercourse. Impaired sexual function can make any form of pleasure beyond desire difficult. Reaching orgasm becomes a feat. And the drop in libido due to hormonal deficiency is made worse. Let us remember that it is not enough to do what the mind wants, we must also see what the body can do! If the pleasure organ is not able to function properly, desire alone is not enough.

The risk is to enter a “vicious circle”: the woman avoids intercourse because of the emotional and physical discomfort she feels and this leads to a diminishing desire for sexual intimacy.

The bladder is also affected. Hormonal decline alters the dynamics of bladder filling and emptying and generates urinary discomfort: incontinence, increased frequency, urgency and a sense of incomplete emptying. Another disorder is post-coital cystitis. It appears 24-48 hours after sexual intercourse due to trauma to the thinned urogenital tissues and may be associated with vulvo-vaginitis.

What solutions do women have at their disposal to combat intimate and sexual disorders?

It is important to have a correct diet and hygiene style, one can use long-term natural therapies and short pharmacological therapies in the acute phase, but above all, I have obtained excellent results with the latest generation of laser therapy for vaginal photorejuvenation with long-lasting benefits. I have been using DEKA’s MonaLisa Touch™ CO2 laser treatment for many years, to the great satisfaction of my patients. And mine too, both as a gynaecologist who helps women solve a not insignificant problem and because I too have undergone this therapy and obtained considerable benefits.

MonaLisa Touch™ restores vaginal lubrication and elasticity and improves the function of the bladder and pelvic floor, restores the vaginal mucosa conditions typical of the fertile age and the aesthetics of the intimate parts with long-lasting effects. It is a highly effective, painless, non-invasive and non-injection therapy, does not stimulate hormone production even locally, and is free of side effects. An excellent alternative to minor surgery, which is not always risk-free, and hormone therapies, especially for women who do not want to or cannot take them.

How does MonaLisa Touch™ work?

Using a special vaginal probe, laser beams are emitted inside the vagina. The transmitted energy increases blood circulation, brings more nourishment and stimulates the production of collagen and elastic fibres through the reactivation of fibrocytes into fibroblasts, the cells responsible for the proper functioning of tissue elasticity including vulvo-vaginal and urinary tissues.
It is not, therefore, a mere assembly of residual elastic fibres, but a true ex-novo production of collagen and cellular matrix.

The mucous membrane is thus regenerated and consequently rejuvenated, becoming hydrated, lubricated and elastic again, with a significant improvement in sexual response and urinary symptoms.

As confirmed by histological studies, one month after the first session the vaginal mucosa already shows clear signs of rejuvenation as well as significant thickening of the mucosa.

This concludes our interview with Dr. Fiammetta Trallo. We will soon publish the second part.

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