Atrophic vaginitis Health Article

Definition

Atrophic vaginitis is an inflammation of the vagina due to thinning and shrinking tissues and a decrease in lubrication.

Causes, incidence, and risk factors

Atrophic vaginitis is typically caused by a decrease in estrogen. Estrogen levels normally drop after menopause. The disorder may occur in younger women who have had surgery to remove their ovaries. Some women develop the condition immediately after childbirth or while breastfeeding, since estrogen levels are lower at these times.

Symptoms

• Burning on urination
• Light bleeding after intercourse
• Painful sexual intercourse
• Slight vaginal discharge
• Vaginal soreness -- itching or burning sensation

Signs and tests

A pelvic examination reveals thin, pale vaginal walls. A wet prep test of vaginal discharge may be done to rule out other causes for the condition. Hormonal studies may be done to determine if you are in menopause.

Treatment

Estrogen replacement therapy may be recommended. Estrogen may be given as a cream, tablet, or ring placed into the vagina, as a skin patch, or in a pill that you take by mouth.

Women may want to discuss the risks and benefits of estrogen replacement therapy with their health care provider.

A water-soluble vaginal lubricant may help relieve pain during intercourse.

Expectations (prognosis)

Proper treatment will usually relieve the symptoms.

Complications

Atrophic vaginitis may make you more prone to vaginal infections caused by bacteria or fungi (yeast).

Atrophic vaginitis can also cause open sores or cracks in the vaginal wall.

Calling your health care provider

Call for an appointment with your health care provider if you are experiencing vaginal dryness or soreness, burning, itching, or painful sexual intercourse that is not alleviated with a water-soluble lubricant.

References

Eckert LO, Lentz GM. Infections of the lower genital tract: vulva, vagina, cervix, toxic shock syndrome, HIV infections. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 22.

Lobo RA. Menopause: endocrinology, consequences of estrogen deficiency, effects of hormone replacement therapy, treatment regimens. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 42.