Atrophic Vaginitis

Atrophic vaginitis is vaginal dryness due to thinning tissue and decreased lubrication. This is more of a problem occurring around menopause, although it can happen whenever there is reduced or lack of oestrogen – whatever may be the cause of this.

Symptoms

• Painful Sex. This may occur because the vagina is smaller, drier and less likely to become lubricated during sex than before the menopause. Also, the skin around the vagina is more fragile, and this can make the problem worse.
• Vaginal Soreness – if the vulva or vagina is sore and red. Vaginal soreness, including itching or burning sensations.

• Vaginal discharge. There may be a white or yellow discharge. Sometimes this is due to an infection. Infection is more likely if the discharge is smelly and unpleasant.
• Vulval Itching. The skin around the vagina is more sensitive and more likely to itch. This can make you prone to scratching, which then makes the skin more likely to itch, and so on. This is called an itch/scratch cycle which can become difficult to break, and can be distressing.
• Urinary problems. Atrophic vaginitis may contribute to various urinary problems. This is because of thinning and weakening of the tissues around the neck of the bladder, or around the urethra (opening for urine). For example, urinary symptoms that may occur include an urgency to get to the toilet, and recurring urinary infections, or simply burning sensation on urination due to thining of the membranes.
• Light bleeding (Post Menopausal Bleeding) may occur on its own, or after intercourse.

Treatments (see also under Vaginal Dryness) link

Not all women have all of the above symptoms. Treatment may depend on which symptoms are the most troublesome. Because the problem is mainly due to a lack of oestrogen, it can be helped by replacing the oestrogen in the tissues.

Hormone Replacement Therapy (HRT)

This means taking oestrogen in the form of a tablet, gel, implant or patches. This may be the best treatment for relieving the symptoms, but some women don’t like the idea of taking HRT. There are advantages and disadvantages of using HRT.

Vaginal (Topical ) Oestrogen – Oestrogen cream, pessary or vaginal ring containing oestrogen restores oestrogen to the vagina and surrounding tissues without giving oestrogen to the whole body. Usually the treatment is used every day for about two weeks, and then twice a week for a further three months. After this the effect of the treatment may be assessed by your doctor. This treatment usually works well but the symptoms may recur some time after stopping the treatment. Repeated courses of treatment are often necessary.

Lubricating gels

If vaginal dryness is the only problem, or hormone creams are not recommended because of other medical problems, lubricating gels may help. There are two gels which are available in the UK that are specifically designed to help the problem of vaginal dryness. They replace moisture. They are Replens® and Sylk®.