Atrophic vaginitis, also known as vaginal atrophy, is an inflammation that occurs in the vaginal canal due to low estrogen production, which leaves the lining of the vagina thinner and dryer, leading to symptoms such as vaginal dryness, itching or irritation, and pain during intimate contact.
Atrophic vaginitis is more common during menopause and is called genitourinary syndrome of menopause. However, other conditions that lead to low estrogen production can also cause atrophic vaginitis, such as postpartum, breastfeeding, surgery to remove the ovaries or use of medicines to treat cancer, for example.
The treatment of vaginal atrophy must be guided by a gynecologist who may recommend the administration of estrogen, for topical or oral use, to alleviate symptoms and prevent the occurrence of other diseases, such as vaginal infections or urinary problems.
Main symptoms
The main symptoms of atrophic vaginitis are:
- Vaginal dryness;
- Burning sensation in the vagina;
- Vaginal itching or irritation;
- Pain or bleeding during intimate contact;
- Thin and liquid vaginal discharge;
- Yellowish discharge with a bad smell;
- Pain or burning when urinating;
- Urinate frequently;
- Stress urinary incontinence;
- Blood in the urine.
Furthermore, it is normal for the vaginal pH to be higher than normal, which can increase the risk of developing recurrent urinary infections or damage to the vaginal tissue. Know how to identify the symptoms of a urinary tract infection.
How to confirm the diagnosis
The diagnosis of atrophic vaginitis is made by the gynecologist through analysis of symptoms and gynecological examination.
In addition, the doctor may order some tests such as a pap smear, urine or hormone level test, ultrasound, or vaginal pH analysis.
Make an appointment with your nearest gynecologist to assess your risk of atrophic vaginitis:
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Possible causes
The possible causes of atrophic vaginitis are:
- Menopause;
- Breast-feeding;
- Post childbirth;
- Uncontrolled diabetes;
- Surgery to remove the ovaries;
- Lack of intimate contact;
- Severe stress;
- Pelvic radiotherapy;
- Chemotherapy;
- Immunological diseases;
- Hypothalamic dysfunction;
- Smoking.
Atrophic vaginitis is caused by low production of estrogen, which is a hormone produced by the ovaries, responsible for regulating the menstrual cycle, protecting the vaginal mucosa and stimulating the production of vaginal secretions.
Atrophic vaginitis can also occur in women undergoing hormonal treatments for breast cancer, using drugs such as tamoxifen, anastrozole, letrozole, exemestane or fulvestrant, for example. Also learn about other types of vaginitis and their causes.
How the treatment is carried out
The treatment of atrophic vaginitis must be guided by a gynecologist who may recommend the application of topical estrogens in the form of a cream or vaginal tablets, such as estradiol, estriol or promestriene. In some cases, the doctor may also prescribe the use of tablets, taken orally, or the application of transdermal patches to the skin.
Furthermore, to reduce discomfort during intimate contact, the doctor may recommend the use of vaginal lubricants.
In cases of urinary infection, your doctor may recommend the use of antibiotics to combat bacteria or painkillers to relieve pain or discomfort when urinating. See how urinary infection is treated.
Bibliography
- BACHMANN, G. A.; et al. Diagnosis and Treatment of Atrophic Vaginitis. American Family Phisician. 61. 10; 3090-3096, 2000
- SHEN, J.; et al. Effects of low dose estrogen therapy on the vaginal microbiomes of women with atrophic vaginitis. Sci Rep. 6. 24380, 2016
- BROTMAN, RM; et al. Association between the vaginal microbiota, menopause status, and signs of vulvovaginal atrophy. Menopause. 25. 11; 1321-1330, 2018
- LEE, A.; et al. Therapeutic Approaches to Atrophic Vaginitis in Postmenopausal Women: A Systematic Review with a Network Meta-analysis of Randomized Controlled Trials, J Menopausal Med. 24.1; 1-10, 2018
- FLORES, S. A.; HALL, C. A. IN: STATPEARLS (INTERNET). TREASURE ISLAND (FL): STATPEARLS PUBLISHING. Atrophic Vaginitis. 2021. Available at: <https://www.ncbi.nlm.nih.gov/books/NBK564341/>. Accessed on March 3, 2022
- FAUBION, SS; et al. Genitourinary Syndrome of Menopause: Management Strategies for the Clinician. . . . Mayo Clin Proc. 92. 12; 1842-1849,
