Atrophic Vaginitis

Atrophic vaginitis is shrinkage, irritation, and dryness of the vagina caused by 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.

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

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 doctor needs to check for infection or the bladder or kidney)
  • Vaginal discharge, often gray-colored with a bad odor, possibly blood streaked (Any spotting like this should be reported to your doctor promptly to make sure it isn’t caused by a more serious problem.)

To diagnose atrophic vaginitis, your doctor will do a pelvic exam to check the health of your vaginal tissue. Your doctor may measure the level of estrogen in your vaginal tissue by taking a sample of the cells (like taking a Pap smear). Your doctor may also check the levels of hormones in your blood.


Low levels of estrogen can be treated with hormone therapy. If you still have a uterus, both estrogen and progesterone are taken. If you no longer have a uterus, you may take estrogen only.

The hormones can be taken as pills. 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 hormone therapy; such as pills, shots, or skin patches, also prevent osteoporosis.

With no treatment, the vaginal atrophy will persist. With hormone therapy, your symptoms will improve as long as you continue the treatment.

If you use estrogen cream, normal vaginal moisture and secretions will return in about 2 to 4 weeks. If you use other forms of hormone therapy, such as pills, this may take 4 to 8 weeks.

To help reduce or prevent symptoms:

  • Use vaginal lubricant such as K-Y jelly or other water-or-glycerin 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 employ a method of birth control and use protection against sexually transmitted diseases (STD).

Note: Published by McKesson Health Solutions LLC, Developed by McKesson Health Solutions LLC, Copyright 2004. All rights reserved.

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