Definition
Atrophic vaginitis is when the tissues that line the vagina become thin, dry, and inflamed. It is most common in women who have gone through menopause.
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Causes
This problem happens when there is a lack of estrogen in the body. This hormone helps keep the skin of the vagina healthy and moist.
Risk Factors
Low estrogen levels are common after menopause . A woman’s ovaries make the hormone until menopause, which happens at about 52 years of age. After menopause, the vaginal walls become thin and less moist.
Other things that may lower estrogen and raise the risk of this problem are:
- Primary ovarian insufficiency
- Hyperprolactinemia
- The use of hormonal therapies
- Cancer treatments that affect the ovaries
- Eating disorders
- Too much exercise
- Smoking
Symptoms
Some women do not have symptoms. Others may have:
- Vaginal dryness
- Vaginal irritation, itching, or burning
- Vaginal pain
- Pain during sex
- Vaginal discharge
- Problems urinating
Diagnosis
You will be asked about your symptoms and health history. A physical exam will be done. A pelvic exam may also be done. This is often enough to make the diagnosis. Vaginal fluids may be tested to confirm it.
Treatment
The goal of treatment is to ease symptoms. This can be done with:
- Vaginal moisturizers or lubricants
- Estrogen therapy, such as pills, creams, suppositories, or rings
- Selective estrogen-receptor modulators (SERMs)
Regular sexual activity can also promote vaginal health by improving blood flow.
RESOURCES
American Congress of Obstetricians and Gynecologists http://www.acog.org
Office on Women's Health—US Department of Health and Human Services http://www.womenshealth.gov
CANADIAN RESOURCES
The Canadian Women's Health Network http://www.cwhn.ca
Women's Health Matters http://www.womenshealthmatters.ca
References
American College of Obstetricians and Gynecologists (ACOG). Practice Bulletin No. 141: management of menopausal symptoms. Obstet Gynecol. 2014 Jan;123(1):202-16, correction can be found in Obstet Gynecol. 2016 Jan;127(1):166.
Atrophic vaginitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/atrophic-vaginitis . Accessed August 4, 2020.
Revision Information
- Reviewer: EBSCO Medical Review Board Beverly Siegal, MD, FACOG
- Review Date: 03/2020
- Update Date: 00/22/2021