What is atrophic vaginitis?

Atrophic vaginitis is shrinkage, irritation, and dryness of the vagina caused by a change in vaginal tissue. This change happens when the level of estrogen in your body decreases. The change in vaginal tissue is called vaginal atrophy.  Tissues become thin and shrink.  The tissue can become easily irritated, causing pain and discharge.

How does it occur?

The ovaries produce estrogen as long as you have menstrual periods. When you go through menopause and stop having periods, the ovaries stop making estrogen. Less estrogen in the body causes the vagina to become dryer. The tissues in and around the vagina become thinner and produce fewer secretions.

Atrophic vaginitis may occur:

1        after menopause

2        after surgical removal of both ovaries

3        after pelvic irradiation.

What are the symptoms?

The symptoms of atrophic vaginitis are:

1        vaginal irritation, pain, or bleeding during intercourse

2        vaginal dryness

3        itching or burning of the vulva (the area around the vaginal opening)

4        burning or pain after urination (if you feel burning during urination, your health care provider needs to check for infection of the bladder or kidney)

5        vaginal discharge, often gray-colored with a bad odor, possibly blood-streaked (Any spotting like this should be reported to your provider promptly to make sure that it isn't caused by a more serious problem.).

How is it diagnosed?

To diagnose atrophic vaginitis, your health care provider will do a pelvic exam to check the health of your vaginal tissue. Your provider may measure the level of estrogen in your vaginal tissue by taking a sample of cells (like taking a Pap smear). Your provider may also check the levels of hormones in your blood.

How is it treated?

Low levels of estrogen can be treated with hormone therapy. If you still have a uterus, 2 hormones are taken: estrogen and progesterone. If you no longer have a uterus, you may take estrogen only.

The hormones can be taken as pills. They are also available in creams, skin patches, vaginal suppositories, vaginal rings, injections, and pellets placed under the skin. The hormone creams help vaginal tissue return to normal. Other forms of hormone therapy, such as pills, shots, or skin patches, also help prevent osteoporosis.

How long do the effects last?

With no treatment, the vaginal atrophy will persist. With hormone therapy, your symptoms will improve as long as you continue the treatment.

If you use an estrogen cream, normal vaginal moisture and secretions will return in about 2 to 4 weeks. If you use other forms of hormone therapy, such as pills, this may take 4 to 8 weeks.

How can I take care of myself and prevent the symptoms of atrophic vaginitis?

To help reduce or prevent symptoms of atrophic vaginitis during or after menopause:

1        Use a vaginal lubricant such as K-Y jelly or other water-or glycerin-based lubricant if you have mild pain during sexual intercourse. Petroleum jelly is not recommended.

2        Avoid chemical irritants such as douches, sprays, and bubble bath.

3        Wipe front to back after urinating or having a bowel movement.

4        Bathe as usual, using a mild soap in the vaginal area.

5        Wear loosely fitting, cotton underwear. Change your underwear every day.

6        Do not wear underwear in bed at night.

7        Avoid wearing pantyhose until itching stops.

If you still have spotting, use unscented sanitary pads instead of tampons.