What is Atrophic Vaginitis?

What is Atrophic Vaginitis?

Atrophic vaginitis is a vaginal disease that usually happens after menopause. When estrogen levels drop, the vaginal walls can become thin, dry, and inflamed. This can be irritating.

Between 10 and 40 percent of women experience symptoms of atrophic vaginitis after menopause, but only 20 to 25 percent seek medical attention.

Others are unable to do so because they are undergoing home treatment or because they feel embarrassed by the sensitive nature of the situation.

Left untreated, it can affect quality of life.

Fast Facts About Atrophic Vaginitis

  • Atrophic vaginitis refers to the dryness of the vagina.
  • About 40 percent of postmenopausal women experience symptoms, but most do not seek treatment.
  • Symptoms include painful intercourse and an increase in urinary tract infections (UTIs).
  • It normally causes a decrease in estrogen following menopause or following treatment with anti-estrogen medications.
  • Topical treatments and hormone replacement therapy (HRT) can relieve symptoms.

Atrophic Vaginitis Symptoms

Atrophic vaginitis can cause vaginal dryness and discharge.

Here are the main indicators of atrophic vaginitis:

  • vaginal dryness
  • Pain or dyspareunia during sexual intercourse
  • Thin, watery, yellow or gray discharge
  • Pallor and thinning of the labia and vagina
  • More frequent urinary tract infections (UTIs)

Symptoms may also be present during the urination process. These include:

  • painful urination
  • blood in the urine
  • increased urination frequency
  • incontinence
  • Increased likelihood and occurrence of infection
  • There may be a decrease in vaginal hair and the vagina may become narrower and less elastic.

Causes of Atrophic Vaginitis

The most common cause of atrophic vaginitis is the decrease in estrogen after menopause. It can also occur after childbirth and can also happen when anti-estrogen drugs are used to treat other conditions.

The ovaries make estrogen until a woman experiences menopause. In the United States, the average age at which menopause occurs is 51. Before menopause, estrogen in a woman’s bloodstream helps protect the skin of the vagina and stimulates vaginal secretions.

When the ovaries stop making estrogen after menopause, the walls of the vagina become thinner and vaginal secretions decrease. Women may have similar changes after giving birth, but these changes are temporary and less severe.

Medications or hormones may be used as part of treatment for breast cancer, endometriosis, fibroids, or infertility to reduce estrogen levels. This reduction can lead to atrophic vaginitis.

Other reasons are:

  • Treatment of the pelvic area
  • uncontrolled diabetes
  • Chemotherapy
  • severe stress
  • Depression
  • intense exercise

Atrophic vaginitis can occur in young women who have had surgery to remove their ovaries. Some women develop the condition when estrogen levels are naturally low, such as while breastfeeding.

Other substances that can cause further irritation to the vagina are soaps, laundry detergents, lotions, perfumes or tissues.

Smoking, tampons, yeast infections, and condoms can also trigger or worsen vaginal dryness.

How Is Atrophic Vaginitis Diagnosed?

Your doctor will perform an examination and ask about your medical history. They may ask about the use of agents that can irritate the area and cause or exacerbate symptoms, such as soap or perfume.

The pH or acidity of the vaginal area is also taken. A pH of 4.6 or higher indicates atrophic vaginitis. The normal pH of this region is 4.5 or less.

Your doctor may also want to screen for infections, especially in cases of discharge or bleeding. A diabetes test can be done to rule out diabetes.

Also, examples of infections that may be present include candidiasis, endometritis, and bacterial vaginosis. Atrophic vaginitis can make the area more susceptible to becoming infected. It can occur alongside an infection.

If the diagnosis is unclear or malignancy is suspected, a biopsy may be taken to rule out cancer.

A vaginal exam is likely to cause discomfort or pain in a patient with atrophic vaginitis.

What is Atrophic Vaginitis Treatment?

Topical treatments can help. For mild cases, a water-soluble vaginal lubricant can help provide relief during intercourse.

Atrophic Vaginitis HRT

Hormone replacement therapy is one of the treatment options for atrophic vaginitis.

Petroleum jelly, mineral oil or other oils are not suitable. These can increase the chance of infection and damage latex condoms or diaphragms.

Hormone replacement therapy (HRT) can deliver estrogen to the whole body as a tablet, gel, patch, or implant. It is effective, but it can have side effects. Patients should discuss the long-term risks of HRT with their doctor.

Localized HRT is applied topically and treatment is focused on the affected area. A low-dose estriol cream can be used to stimulate rapid growth and repair of vaginal epithelial cells.

Vaginal tablets, creams, rings, and pessaries can be applied internally to focus the estrogen supply into the vaginal area.

Regular exercise is important as it keeps blood flow and genital circulation high. Experimenting with diet may also prove to be effective. Plant estrogens, flaxseed, fish oils, and black cohosh can help treat atrophic vaginitis.

Can Atrophic Vaginitis Be Prevented?

Before the condition worsens, using vaginal estrogen may be a way to protect the vagina.

Regular sexual activity can help prevent atrophic vaginitis. Using a water-soluble vaginal lubricant can soothe mild cases during intercourse.

As long as the vagina has adequate estrogen levels, sexual activity can also show benefits for the flexibility and flexibility of the area. Women who are sexually active report less symptoms of atrophic vaginitis than women who do not have regular sexual intercourse.

MedicalNewsToday,What’s to know about atrophic vaginitis?, 2018

References

Bachmann, GA & Nebadunsky, NS (2000, May 15). Diagnosis and treatment of atrophic vaginitis. American Family Physician, 61(10), 3090-3096. Retrieved from http://www.aafp.org/afp/2000/0515/p3090.html

Kingsberg, S. & Krychman, ML (2013, March 27). Resistance and barriers to local estrogen therapy in women with atrophic vaginitis. Journal of sexual medicine, 10, 1567-1574. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/jsm.12120/full

Lynch, C. (2009). Vaginal estrogen therapy for the treatment of atrophic vaginitis. Journal of Women’s Health, 18(10), 1595-1606. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19788364

Mac Bride, MB, Rhodes, D., & Shuster, L. (2010, January). Vulvovaginal atrophy. Swimsuit Clinic Proceedings, 85(1), 87-94. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2800285/

menopause (2016, September). Retrieved from http://www.hormone.org/diseases-and-conditions/womens-health/menopause

Newson, L. (2016, February 26). Vaginal dryness (atrophic vaginitis). Retrieved from https://patient.info/health/vaginal-dryness-atrophic-vaginitis

Newson, L. (2016, February 26). Atrophic vaginitis. Retrieved from https://patient.info/doctor/atrophic-vaginitis

Nyirjesy, P. (2014, December). Management of persistent vaginitis. Obstetrics & Gynecology, 124(6), 1135-1146. Retrieved from http://journals.lww.com/greenjournal/Abstract/2014/12000/Management_of_Persistent_Vaginitis.11.aspx

Vaginal atrophy (atrophic vaginitis). (2017). Retrieved from https://www.drugs.com/health-guide/vaginal-atrophy-atrophic-vaginitis.html

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