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McKesson Clinical Reference Systems: Women's Health Advisor 2002.2
Illustration
Atrophic Vaginitis
What is atrophic vaginitis?
Atrophic vaginitis is vaginal irritation and dryness caused
by a change in vaginal tissue. This change happens when the
level of estrogen in your body decreases. The change in
vaginal tissue is called vaginal atrophy.
How does it occur?
The ovaries produce estrogen as long as you have menstrual
periods. When you go through menopause and stop having
periods, the ovaries stop making estrogen. Less estrogen in
the body causes the vagina to become dryer. The tissues in
and around the vagina become thinner and produce fewer
secretions.
Atrophic vaginitis may occur:
- after menopause
- while you are producing milk for breast-feeding
- after surgical removal of both ovaries
- after pelvic irradiation.
What are the symptoms?
The symptoms of atrophic vaginitis are:
- vaginal irritation, pain, or bleeding during intercourse
- vaginal dryness
- itching or burning of the vulva (the area around the
vaginal opening)
- burning or pain after urination (if you feel burning
during urination, your health care provider needs to
check for infection of the bladder or kidney)
- vaginal discharge, possibly blood-streaked (any spotting
like this should be reported to your provider promptly to
make sure that it isn't caused by a more serious
problem).
How is it diagnosed?
To diagnose atrophic vaginitis, your health care provider
will do a pelvic exam to check the health of your vaginal
tissue. Your provider may measure the level of estrogen in
your vaginal tissue by taking a sample of cells (like taking
a Pap smear). Your provider may also check the levels of
hormones in your blood.
How is it treated?
Low levels of estrogen can be treated with hormone
replacement therapy (HRT). If you still have a uterus, two
hormones are taken: estrogen and progesterone. If you no
longer have a uterus, you may take estrogen only.
The hormones can be taken as tablets. They are also
available in creams, skin patches, vaginal suppositories,
vaginal rings, injections, and pellets placed under the
skin. The hormone creams help vaginal tissue return to
normal. Other forms of HRT, such as pills, shots, or skin
patches, also help prevent osteoporosis.
How long do the effects last?
With no treatment, the vaginal atrophy will persist. With
HRT, your symptoms will improve as long as you continue the
treatment.
If you use an estrogen cream, normal vaginal moisture and
secretions will return in about 2 to 4 weeks.
How can I take care of myself and prevent the symptoms of
atrophic vaginitis?
To help reduce or prevent symptoms of atrophic vaginitis
during or after menopause:
- Use a vaginal lubricant such as K-Y jelly or other
water-or glycerine-based lubricant if you have mild pain during
sexual intercourse. Petroleum jelly is not recommended.
- Avoid chemical irritants such as douches, sprays, and
bubble bath.
- Wipe front to back after urinating or having a bowel
movement.
- Drink plenty of liquids.
- Bathe as usual, using a mild soap in the vaginal area.
- Wear loosely fitting, cotton underwear. Change your
underwear every day.
- Do not wear underwear in bed at night.
- Avoid wearing pantyhose until itching stops.
- If you still have periods or spotting, use unscented
sanitary pads instead of tampons.
- If spermicidal foams, gels, and creams irritate your
vagina, avoid using them. However, make sure you
practice good birth control and protection against
sexually transmitted disease.
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