What is Atrophic Vaginitis, and what causes it?
Atrophic vaginitis occurs when vaginal tissues thin out and lose elasticity due to the loss of estrogen. This “loss” typically occurs shortly before and during menopause (When menstruation subsides) or after surgical removal of the ovaries. The major estrogen found in women, estradiol, is produced by the ovaries during childbearing years. As ovarian estrogen production slows – symptoms of menopause, including genital or urinary symptoms, may occur.
What are the symptoms?
About 50% of menopausal women will begin to have symptoms of Atrophic Vaginitis within 2-3 years of menopause. Those symptoms may include: vaginal dryness, painful intercourse, vaginal itching, and abnormal vaginal discharge. Also, women may experience urinary symptoms such as painful urination, urinary urgency or frequency of urination. Some women report urinary incontinence or increased urinary tract infections.
How is it treated?
Vaginal estrogen appears to be the most effective treatment for Atrophic Vaginitis. About 90% of patients will have improvement of their symptoms within 3 weeks of initiating treatment. It is important to note that women, who are taking other forms of hormones for menopause, may still experience Atrophic Vaginitis; these women may benefit from addition of vaginal estrogen. Vaginal preparations are available such as conjugated equine estrogens, estradiol or estrone. Synthetic and bio-identical preparations are available. Vaginal estrogen may be delivered via cream, tablet, ring, or pessary.
What are the risks and side-effects?
Vaginal estrogen may have the following rare side effects: vulvar itching or irritation, vaginal discharge, and vaginal bleeding; however, a switch to a different dosage or preparation may reduce or eliminate these problems. Abnormal uterine bleeding has not been shown in studies to be related to the use of vaginal estrogen. Studies show that vaginal estrogen appears to be a safe option for women who have had breast cancer. If you have cancer, you should discuss this with your healthcare provider.
What are some other treatments for Atrophic Vaginitis?
Other treatments include: water soluble lubricants, DHEA, Vitamin E suppositories and herbal preparations such as black cohosh, soy and red clover. Many of the herbal preparations contain plant estrogens thus they may have similar risks as other forms of vaginal estrogen.
Call McDowell Mountain Gynecology at 480-483-9011 and make an appointment with Jill Antell if you are experiencing vaginal dryness and would like to discuss treatment options.