• Atrophic Vaginitis

    Definition

    Atrophic vaginitis is characterized by redness, itching, and dryness of the vagina. Over time there may be narrowing and shrinkage of the vaginal opening and the vagina itself. This problem happens after menopause in up to 75% of all women, and can also happen to some women after childbirth. Atrophic vaginitis is usually easily treated, so contact your doctor if you think you may have this problem.
    Vagina
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    Causes

    A woman’s ovaries make estrogen until menopause, which happens at about 52 years of age. Before menopause, estrogen in a woman’s bloodstream helps keep the skin of the vagina healthy and stimulates vaginal secretions. After menopause, when the ovaries stop making estrogen, the walls of the vagina become thin, and vaginal secretions are lessened. Similar changes can happen to some women after childbirth, but in this case these changes are temporary and less severe.

    Risk Factors

    The following factors increase your chances of getting atrophic vaginitis or having more severe symptoms. If you have any of these risk factors, be sure to tell your doctor.

    Symptoms

    Symptoms of atrophic vaginitis can range from minor to severe. They include:
    • Vaginal dryness
    • Vaginal itching or burning
    • Vaginal pain
    • Problems with sexual intimacy because of painful intercourse

    Diagnosis

    Your doctor will ask about your symptoms and medical history, and perform a physical examination. He or she may refer you to a doctor specializing in women’s reproductive health (a gynecologist). Tests used to diagnose atrophic vaginitis include:
    • A test of the acid-base balance (pH balance) of the vagina
    • A swabbing of a small part of the vaginal wall—The cells are collected and tested to determine if estrogen is present.

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options for atrophic vaginitis include:
    • Oral estrogen therapy
    • Estrogen-containing vaginal creams or vaginal suppositories

    Prevention

    If you are nearing menopause, take the following steps to help reduce your chances of getting atrophic vaginitis:
    • Ask your doctor if estrogen therapy is right for you.
    • Stay sexually active.
    • Use a vaginal lubricant.
    • Drink plenty of fluids each day.

    RESOURCES

    American Family Physician http://www.aafp.org

    The American Congress of Obstetricians and Gynecologists http://www.acog.org/publications/patient%5Feducation/

    Women's Health.gov 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

    Atrophic vaginitis. A treatable cause of vaginal dryness. Mayo Clin Womens Healthsource . 2002;6:6.

    Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician . 2000;61:3090-3096.

    Castelo-Branco C, Cancelo MJ, Villero J, Nohales F, Julia MD. Management of postmenopausal vaginal atrophy and atrophic vaginitis. Maturitas . 2005 [Epub ahead of print].

    Nothnagle M, Taylor JS. Vaginal estrogen preparations for relief of atrophic vaginitis. Am Fam Physician . 2004;69:2111-2112.

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