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Atrophic vaginitis

Last reviewed

What is atrophic vaginitis?

  • Atrophis vaginitis is a skin condition of the vulva and vagina.
  • It happens when a hormone called estrogen is low or lacking in the body.
  • You can get it at any age but not all women get it.
  • It is often found in women who are menopausal:  Women whose ovaries have stopped making estrogen.

It can also be seen in women who:

  • Are breastfeeding

  • Using Depo-medroxyprogesterone (Depo-ProveraTM), Tamoxifen (NolvadexTM), Letrozole (FemaraTM)

  • Have had their ovaries surgically removed.

Lowering estrogen levels can cause skin changes.  This can happen in the vulvar and vaginal areas as well as the urethra and bladder.

  • The skin becomes thin and is more easily irritated or injured.

What are the signs and symptoms?

  • Problems with urination (peeing), such as:
    • Frequency (peeing often)
    • Burning
    • Urgency (needing to pee quickly)
    • Loss of urine
    • Pain
    • Urinating at night
  • Vulvar burning and/or itching
  • Bleeding or spotting
    • Come in for an evaluation if this happens often or is not normal.
  • Pain with sex
  • Vaginal dryness

How is it tested?

  • Your health care provider will check your vulva and vaginal skin.
  • We will look at a sample of your vaginal discharge with a microscope.
  • This will be used to decide if you have the changes normally seen with atrophic vaginitis.

What is the treatment?

It can be one of these:

Types of Estrogen Replacement Therapy are:

Topical or Vaginal Estrogen:

  • Gives estrogen directly into the vagina with an applicator or put directly on the vulvar skin.

Vulvar-Vaginal Topical Cream:

  • This is put into the vagina with a vaginal applicator or put directly to the vulvar skin.

Vaginal Tablet or Ring:

  • The tablet is put in the vagina with an applicator.
  • You will put the ring into your vagina.

Systemic Estrogen:

  • Gives estrogen to the whole body.  This is normally safe, but for some women this is not a good choice.  Your health care provider will let you know if this is safe for you.
  • If you still have a uterus and are on systemic estrogen, you will also get a hormone called progesterone.

Oral Estrogen:

  • This involves taking an estrogen pill as told by your health care provider.

Transdermal Patch:

  • This is a patch that is put on 1 or 2 times a week.
  • It gives the estrogen hormone through the skin.
  • It is put on the upper parts of your body.

Dietary:

  • Plant derived phytoestrogens can be found in soy milk, soy nuts, tofu, or black cohosh.
  • You can also get phytoestrogens as nutritional supplements called soy isoflavones.
  • The amount of estrogen in dietary sources is unpredictable.  So, please talk with your provider first.

 

Other Helpful Hints:

  • Use a lubricant with sex. Vegetable oil, olive oil, coconut oil are good choices.
  • Place a small amount of vegetable oil on the vaginal applicators to put it in.
  • Cooling packs, as needed.
  • Baking soda baths.
    • Soak in lukewarm (not hot) bath water with 4 to 5 tablespoons of baking soda.
    • Soak 1 to 3 times a day for 10 minutes.

Call:

  • The Obstetrics Gynecology Clinic at 319-356-2294 Monday through Friday from 8 a.m. - 4:30 p.m.

For urgent questions or concerns:

  • Call toll-free at 800-777-8442, 24 hours a day.
  • Ask for the gynecology resident on call.
  • You may be asked some questions when using the toll-free number.

Send a MyChart message for non-urgent questions or concerns.