Diseases

Vaginal atrophy

When a woman’s estrogen levels drop, the walls of her vagina become dry, thin, fragile and inflamed; this is known as atrophy of the vagina. This condition normally occurs after menopause.

Published December 30, 2021

Causative & risk factors

The cause of vaginal atrophy is a dip in the body’s estrogen levels. The commonest reason behind this is menopause. Also surgical menopause caused by bilateral oophorectomy can give rise to atrophic vaginitis. Breast-feeding women are also prone to this condition. Cancer treatments such as chemotherapy or radiation therapy to the pelvic area can also lead to atrophic vaginitis.

Certain factors increase a woman’s risk of developing atrophic vaginitis; such as smoking, lack of sexual activity and having had no vaginal births.

Clinical presentation

The woman with vaginal atrophy experiences dryness, itching and burning in the vagina. There may be an abnormal discharge from the vagina. She may have a frequent urging to urinate and experience burning pain thereafter. Urinary incontinence can be seen in some women. A higher frequency of developing urinary tract infections has been noted in these women. Coition may become a painful experience, and may be followed by slight bleeding. The vaginal canal loses its elasticity and may feel shorter and tighter. There is an increased risk of catching vaginal infections.

Investigations

Vaginal atrophy can be easily diagnosed on the basis of the woman’s medical history, her symptoms and a pelvic examination. The pH of the vagina may be tested using a paper indicator strip. A routine urine exam is performed if the woman presents with urinary symptoms.

Treatment

Since the vagina becomes dry, vaginal moisturizers are recommended to lubricate the vagina. If the woman experiences discomfort during sexual intercourse, she is advised to use lubricant creams.

Estrogen creams are prescribed to relieve the vaginal symptoms. Topical estrogen can also be given in the form of a vaginal ring or a vaginal tablet. Sometimes, estrogen is given orally to combat the symptoms.

Some women may need hormone replacement therapy using both, estrogen and progesterone.

In some instances, vaginal atrophy can be prevented by indulging in regular sexual activity.