Vaginal Atrophy

Summary about Disease


Vaginal atrophy, also known as atrophic vaginitis, is the thinning, drying, and inflammation of the vaginal walls that can occur when your body has less estrogen. It most commonly occurs after menopause, but can also result from other conditions that affect estrogen levels.

Symptoms


Vaginal dryness

Vaginal burning

Vaginal discharge

Genital itching

Urinary urgency

Painful urination

More frequent urinary tract infections

Urinary incontinence

Light bleeding after intercourse

Discomfort during intercourse

Decreased vaginal lubrication during sexual activity

Shortening and tightening of the vaginal canal

Causes


The primary cause is a decrease in estrogen production. This can occur due to:

Menopause

Surgical removal of ovaries (oophorectomy)

Radiation therapy to the pelvic area

Chemotherapy

Breastfeeding

Certain medications, such as aromatase inhibitors (used to treat breast cancer) and anti-estrogen medications

Medicine Used


Vaginal estrogen: Creams, tablets, or rings that release estrogen directly into the vaginal tissues.

Systemic estrogen: Estrogen pills, patches, or gels that affect the entire body. Hormone Therapy (HT).

Vaginal moisturizers: Nonhormonal, over-the-counter lubricants applied regularly to keep the vaginal tissues moist.

Vaginal lubricants: Used during sexual activity to reduce discomfort.

Ospemifene (Osphena): An oral medication that acts like estrogen on the vaginal lining.

DHEA (prasterone): A vaginal insert that is converted into estrogen inside vaginal cells.

Is Communicable


No, vaginal atrophy is not communicable or contagious. It is a result of hormonal changes within the body.

Precautions


Use vaginal moisturizers regularly, even when not sexually active.

Use vaginal lubricants during sexual activity.

Maintain regular sexual activity to promote blood flow to the vaginal area.

Discuss hormone therapy options with your doctor if appropriate.

Avoid douching, as it can disrupt the natural balance of bacteria in the vagina.

Avoid scented soaps, lotions, and other products in the genital area that may cause irritation.

How long does an outbreak last?


Vaginal atrophy is not an "outbreak" but rather a chronic condition. Symptoms can persist indefinitely if left untreated. Treatment can alleviate symptoms, but they may return if treatment is stopped.

How is it diagnosed?


Pelvic exam: A physical examination of the vagina, cervix, and uterus.

Medical history: Discussion of symptoms, menstrual history, and other relevant medical conditions.

Vaginal pH test: To measure the acidity of the vagina.

Urine test: To rule out urinary tract infections.

Blood tests: To measure hormone levels.

Timeline of Symptoms


The onset of symptoms can vary.

Perimenopause: Symptoms may begin gradually during the years leading up to menopause.

Postmenopause: Symptoms often become more pronounced after menopause.

Other Causes: If caused by medication or other medical treatment, symptoms may appear relatively quickly after the treatment begins. Symptoms can fluctuate in severity over time.

Important Considerations


Vaginal atrophy can significantly impact quality of life, including sexual function and overall well-being.

It is important to discuss symptoms with a healthcare provider to determine the most appropriate treatment plan.

Treatment options should be tailored to the individual's specific needs and medical history.

Long-term management may be necessary to control symptoms and prevent complications.

Women who have had breast cancer should discuss the risks and benefits of hormone therapy with their oncologist.