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.

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, or after ovarian failure or removal, 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

Factors that may increase your chance of more severe symptoms of atrophic vaginitis include:

• Smoking
• History of having childbirth by cesarean section
• Never having been pregnant
• Anti-estrogen medications

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

You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a doctor specializing in women’s reproductive health.

Your vaginal fluids may be tested. This can be done with:

• A test of the acid-base balance (pH balance) of the vagina
• A swabbing of a small part of the vaginal wall

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
• Vaginal moisturizer or lubricant

Prevention

To help reduce your chance of 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

Office on Women’s Health http://www.womenshealth.gov

Women’s Health Matters http://www.womenshealthmatters.ca

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

Castelo-Branco C, Cancelo MJ, et al. Management of postmenopausal vaginal atrophy and atrophic vaginitis. Maturitas. 2005;52 Suppl 1:S46-S52.

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