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Atrophic vaginitis can cause itching, burning, and sexual discomfort — but treatments are available

Inflamed vaginal tissue may not be something most women want to talk about, but it can be painful and life altering for those who have it. Atrophic vaginitis, the medical term for this condition, occurs as a result of deterioration of the vaginal tissue. It's a common condition in postmenopausal women because as estrogen levels drop, the tissue that lines the vagina becomes thinner and more easily damaged. The top layer of cells is often lost entirely, exposing the layer below, which is more vulnerable to inflammation or infection. Vaginal secretions also decline, which can make intercourse painful. Women with atrophic vaginitis may also experience vaginal itching, burning, frequent urination, or vaginal discharge.

Women can treat this condition topically with estrogen creams, tablets (Vagifem), or an estrogen-releasing ring placed in the vagina (Estring). Oral estrogen, available with a doctor’s prescription, will also restore vaginal tissue. Vaginal lubricants offer an alternative for women wary of using estrogen. Moisturizers such as Replens, Astroglide, and Lubrin can reduce symptoms and make sexual intercourse more comfortable. They are available over the counter.

Sexual activity may also help preserve the vaginal epithelium, presumably by increasing blood flow to the area. A study of 52 postmenopausal women found significantly less vaginal atrophy among those who had intercourse more than 3 times a week than among those who had intercourse less than 10 times per year. Sexual activity also helps maintain an acidic vaginal climate, which offers some protection against infection.

Women with atrophic vaginitis are also at risk for infectious vaginitis. The microorganisms that usually cause problem for women— most commonly Candida (yeast), Gardnerella, or Trichomonas—are more likely to strike women with atrophied vaginal tissue. If a woman’s atrophic vaginitis symptoms become more pronounced or if the vaginal discharge changes or increases, she should be tested for infectious vaginitis and skin problems of the vulva, which usually respond quickly to topical and oral medications.

July 2003 Update

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