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:

• Are breastfeeding

• Using Depo-medroxyprogesterone (Depo-Provera^TM), Tamoxifen (Nolvadex^TM), Letrozole (Femara^TM)

• 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:

• 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.