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Concept
Atrophic vaginitis
Summary
Atrophic vaginitis is inflammation of the vagina as a result of tissue thinning due to not enough estrogen. Symptoms may include pain with sex, vaginal itchiness or dryness, and an urge to urinate or burning with urination. It generally does not resolve without ongoing treatment. Complications may include urinary tract infections.
The lack of estrogen typically occurs following menopause. Other causes may include when breastfeeding or as a result of specific medications. Risk factors include smoking. Diagnosis is typically based on symptoms.
Treatment is generally with estrogen cream applied to the vagina. Other measures that may help include vaginal lubricants. It is recommended that soaps and other irritants are avoided. About half of postmenopausal women are affected. Many however are not being treated. Women often report reduced enjoyment in sex as well as life generally.
After menopause the vaginal epithelium changes and becomes a few layers thick. Many of the signs and symptoms that accompany menopause occur in atrophic vaginitis. Genitourinary symptoms include
dryness
pain
itching
burning
soreness
pressure
white discharge
malodorous discharge due to infection
painful sexual intercourse
bleeding after intercourse
painful urination
blood in the urine
increased urinary frequency
incontinence
increased susceptibility to infections
decreased vaginal lubrication
urinary tract infections
painful urination
difficulty sitting
difficulty wiping
Since women can have signs and symptoms that could be attributed to other causes, diagnosis is based upon the symptoms that cannot be better accounted for by another diagnosis. Lab tests usually do not provide information that will aid in diagnosing. A visual exam is useful. The observations of the following may indicate lower estrogen levels: little pubic hair, loss of the labial fat pad, thinning and resorption of the labia minora, and the narrowing of the vaginal opening. An internal exam will reveal the presence of low vaginal muscle tone, the lining of the vagina appears smooth, shiny, pale with loss of folds.
Official source
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