ATROPHIC VAGINITIS

Atrophic vaginitis is a condition that causes the vagina and tissues near the vagina to get dry, thin, and inflamed. This can be uncomfortable or make sex painful. Atrophic vaginitis is sometimes called “vaginal atrophy.”

Atrophic vaginitis happens when your body does not make enough of a hormone called estrogen. This often happens after you have gone through menopause (meaning you have stopped having a monthly period). It can also happen if your ovaries were removed, if you take certain medicines, or if you are breastfeeding.

The symptoms include:

• Vaginal dryness
• Vaginal burning or irritation
• Making less lubrication during sex
• Pain during sex
• Bleeding when something touches or rubs the vagina, for example, after sex. (If you have this symptom, be sure to see a doctor.)
• Vaginal discharge (leaking fluid from the vagina)
• Urinary problems, such as having to urinate often, having pain with urination, or leaking urine. (If you have these symptoms, be sure to see a doctor.)

No. There is no test. But your doctor or nurse should be able to tell if you have it by learning about your symptoms and doing an exam.

Yes. Some people feel better if they use lubricants before sex and use a vaginal moisturizer (sample brand names: Replens, K-Y SILK-E), several times a week. Vaginal moisturizers are not the same as lubricants. They help keep the vagina moist all the time, not just during sex.

See your doctor or nurse if you have symptoms of atrophic vaginitis and they bother you.

Some people never tell their doctor they are having symptoms. Often they are embarrassed or think the symptoms are a normal part of aging. But this is a common medical issue and there are treatments that can help.

The most effective treatment for atrophic vaginitis is the hormone estrogen. When using estrogen to treat atrophic vaginitis, doctors recommend “vaginal estrogen.” Vaginal estrogen is any form of estrogen that goes directly into the vagina. It comes in creams, tablets, or a flexible ring. Vaginal estrogen comes in small doses that don’t increase the levels of estrogen in other parts of the body very much.

Estrogen also comes in higher doses in a pill, a skin patch, or a different vaginal ring. These are sometimes called “hormone replacement therapy.” Vaginal estrogen is better for treating symptoms of atrophic vaginitis. But if you have other menopause symptoms, such as hot flashes or night sweats, your doctor can talk to you about whether higher-dose estrogen is an option. There are different risks and benefits, and some people cannot safely take high doses of hormones.

Besides estrogen, medicines that can treat atrophic vaginitis include:

• Ospemifene(brand name: Osphena) is similar to estrogen, but is not estrogen. It comes as a pill you take once a day. It can cause hot flashes.
• Prasterone, also called dehydroepiandrosterone (DHEA), is a medicine that you put into your vagina once a day. It comes as a “suppository,” which is similar to a tablet or pill but goes directly into the vagina.

Other treatments are also available, but are not used as often.