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Atrophic Vaginitis

Atrophic Vaginitis

  • Female reproductive organs

Definition

Atrophic vaginitis is a thinning of a woman's vaginal tissues. This condition usually occurs after a woman has gone through menopause.

What is going on in the body?

Low levels of estrogen cause a loss of lubrication, or moisture, in the vaginal tissues. At the same time, the vagina receives less blood supply and nutrients. These changes together can cause the vaginal wall to thin out.
Women have low levels of estrogen at certain times of life:
  • before puberty
  • while breast-feeding
  • after menopause

Risks

What are the causes and risks of the condition?

This condition occurs when the ovaries produce too little estrogen. It is very rare in children. In women who have this condition, infection and trauma during intercourse become more likely.

Prevention

What can be done to prevent the condition?

Healthcare professionals may prescribe hormone therapy (H T) to prevent and treat atrophic vaginitis. HT usually consists of estrogen. A woman can take estrogen in several forms:
  • pills
  • skin patches
  • creams, which are applied to the vaginal tissues
  • vaginal rings which release estrogen
Some women may benefit from a diet high in foods that contain plant estrogens, known as phytoestrogens. These include soy, flaxseeds, and red clover.

Diagnosed

How is the condition diagnosed?

A healthcare professional will do a pelvic exam to assess the health of the vaginal tissue. He or she can also check vaginal discharge for signs of infection. Typical signs include large numbers of white blood cells and bacteria.

Long Term Effects

What are the long-term effects of the condition?

Long-term effects of this condition include chronic vaginal yeast infections, although often the irritation from atrophy can be confused with the symptoms of yeast infection. Also common are scrapes and scratches of the vulva and vagina that can cause painful intercourse.

Other Risks

What are the risks to others?

Atrophic vaginitis itself is not communicable. But, sometimes an infection develops as a result of the condition, and this infection may be passed to a sexual partner during intercourse.

Treatments

What are the treatments for the condition?

HT is the treatment for low levels of estrogen in a woman's body. Vaginal creams used to treat this condition are usually applied two or three times a week. Estrogen vaginal tablets my be inserted two to three times a week for local therapy.
Estrogen oral tablets may be given alone if the uterus has been removed. Otherwise, estrogen may be combined with progestin. Skin patches of estrogen may be used instead of pills. The patches only need to be changed once or twice a week, so they can be more convenient to use.
A woman with this condition can also use these measures to help prevent irritation of the vagina:
  • Moisten the vaginal opening with K-Y jelly or glycerin-based ointments before intercourse.
  • Spend more time on intimacy and foreplay before vaginal penetration.
  • Avoid chemical irritants such as spermicides, douches, bubble baths, and deodorant sprays.
  • Use gentle soaps for bathing.
  • Wipe from front to back after urinating or having a bowel movement.
  • If there is vaginal bleeding, use unscented sanitary napkins instead of tampons.
  • Avoid tight pantyhose or nylon underwear.

Side Effects

What are the side effects of the treatments?

Estrogen creams can cause vaginal spotting. The cream itself may also be irritating. Estrogen pills and patches may cause the following side effects:
  • abdominal bloating and cramping
  • breast tenderness
  • nausea
  • vaginal spotting or bleeding
These side effects generally go away within about a month after starting HT, as the body adjusts.

After Treatment

What happens after treatment for the condition?

Without treatment, this condition and its symptoms will not go away. With treatment, symptoms will improve for as long as the treatment lasts. Normal vaginal moisture usually returns after 2 to 4 weeks of vaginal cream therapy.

Monitor

How is the condition monitored?

Once treatment has eliminated the symptoms, a woman needs to make follow-up visits to her healthcare professional, and report any new or worsening symptoms. The healthcare professional should do a physical examination, including a pelvic exam, once a year.

Sources

Maternity and Gynecological Care, The Nurse and the Family, Bobak et al., 1989.

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