Atrophic Vaginitis: Diagnosis and Treatment

Abstract

ABSTRACT Atrophic vaginitis is an inflammation of the vagina which develops when there is a significant decrease in estrogen levels after menopause. The initial and most common symptom is often lack of lubrication during intercourse. Eventually, persistent vaginal dryness may occur leading to dyspareunia. The onset of symptoms may not be immediate and may occur 3 to 4 years after menopause. Nonhormonal treatment includes vaginal moisturizers for atrophy symptoms, lubricants for dyspareunia, hyaluronic acid vaginal tablets and phtoestrogens. Estrogens are known to increase vascularity, secretions and thickness of vagina and decrease vaginal pH. They can be given both systemically or vaginally. Local therapy has been found to be more efficacious than systemic therapy and has the advantage of not having systemic adverse effects. They can be given as pessaries, creams or rings. Delivery system used should be convenient to patient so that therapy is consistent, as that is critical for effect. Improvement in vaginal atrophy symptoms starts within a few weeks of starting vaginal estrogen but, some may need to use it for 4 to 6 weeks before adequate improvement is observed. Selective estrogen receptor modulator bazedoxifene may be combined with estrogens. Postmenopausal vaginal atrophy is a common cause of easily treatable distressing symptoms which severely affect quality of life. How to cite this article Ghumman S. Atrophic Vaginitis: Diagnosis and Treatment. J South Asian Feder Menopause Soc 2013;1(1):4-12.