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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.

Vagina
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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.

Prevention

There are no known methods to prevent this health problem.

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.

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