Atrophic vaginitis
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:
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Are breastfeeding
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Using Depo-medroxyprogesterone (Depo-ProveraTM), Tamoxifen (NolvadexTM), Letrozole (FemaraTM)
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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.
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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:
- Vulvar Skin Care Guidelines
- Vaginal moisturizers (such as Replens, KY liquid beads)
- Estrogen replacement therapy
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.