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Women who are breastfeeding may experience signs very similar to those of menopause, such as vaginal dryness, tissue atrophy and pain during sexual intercourse. The conclusion is from a systematic review published in the scientific journal, which analyzed 65 studies and showed that more than half (53.6%) of breastfeeding women experience vaginal dryness and almost two thirds develop vaginal atrophy (63.9%).
The condition was called . According to the authors, these manifestations are directly related to the drop in estrogen levels during breastfeeding. This hormone, essential for maintaining vaginal lubrication and elasticity, remains in low concentration while the woman produces prolactin, the hormone responsible for the production of breast milk.
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Despite the high frequency identified in research, the syndrome is still poorly recognized and rarely identified during postpartum consultations. This is because most women do not associate the symptoms with breastfeeding and tend to normalize pain, discomfort and lack of sexual desire, believing that they are part of the mothering process.
Furthermore, postpartum follow-up usually focuses on the baby and issues such as breastfeeding, vaccinations and , but not on the mother’s sexual health. “There is no systematic screening of these symptoms. In general, they only appear when the woman raises the complaint spontaneously or when they are investigated in research. If the patient does not speak up, it often goes unnoticed”, says gynecologist and obstetrician Rômulo Negrini, maternal and child medical coordinator at Einstein Hospital Israelita.
A , but also the woman’s emotional well-being and daily routine. According to Negrini, these symptoms impact sexual desire, frequency and satisfaction.
“Although the study does not focus primarily on qualitative emotional impacts, it is reasonable to infer that pain and discomfort can generate frustration, shame, decreased self-esteem, difficulties in the marital relationship and even a feeling of isolation. Pain is an important limitation of everyday life and can even interfere with the care of the baby”, highlights the expert.
According to the results of the investigation, three months after giving birth, 60% of women reported pain during sexual intercourse. This number drops to 40% in six months and to 28% in a year. Furthermore, almost three in four women presented some degree of sexual dysfunction, measured using the Female Sexual Function Index (IFSFI), a questionnaire that assesses aspects such as desire, arousal, lubrication, orgasm, satisfaction and pain. The higher the score, the better the sexual function.
Treatment without harm to breastfeeding
Although there are still a lack of specific guidelines for managing the syndrome, Negrini emphasizes that there are safe alternatives to alleviate symptoms without compromising breastfeeding. “Treatment can begin with non-hormonal measures, such as lubricants during intercourse, continuous vaginal moisturizers, behavioral adjustments and even pelvic physiotherapy. In selected cases, we can resort to local hormonal treatments, always with caution and medical supervision”, he explains. “It is essential to show women that they do not need to suffer, as there are resources available.”
Another challenge is the taboo surrounding the topic. It is estimated that up to 70% of women do not seek help to deal with their symptoms. “It is up to the gynecologist to ask about sexual health and create an environment of trust so that women feel comfortable talking. Furthermore, we need to prepare the entire healthcare team, which includes doctors, nurses, physiotherapists and breastfeeding consultants, to recognize that these symptoms are common and treatable, without stigmatizing or minimizing complaints”, highlights the gynecologist.
For him, it would also be important to invest in educational activities aimed at pregnant and postpartum women. “Brochures, videos, mothers’ groups and workshops can provide guidance on hormonal changes, what to expect during breastfeeding and how to seek help. Information is essential”, he says.
Recognition of the syndrome can also contribute to rethinking the postpartum follow-up model. “When a set of symptoms is named, we legitimize its existence. This facilitates diagnosis, communication between professionals and patients, the development of research and even the creation of treatment guidelines. In addition to improving individual care, recognition can have an impact on health policies and the quality of life of thousands of women”, he concludes.
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