Patient Information: Vulvar - Vaginal Disease

Atrophic Vaginitis

What is Atrophic Vaginitis?
Atrophic Vaginitis is a skin condition of the vulva and vagina. It occurs when a hormone called estrogen is lacking in the body. Atrophic vaginitis can occur at any age. It most commonly occurs in women who are menopausal and in women whose ovaries have stopped making estrogen. It can also be seen in women who are breast feeding, using Depo-Provera, or have had their ovaries removed. Decreasing estrogen levels can cause skin changes in the vulvar and vaginal areas as well as the urethra and bladder. With these changes, the skin becomes thin and more easily damaged. Atrophic vaginitis does not affect all women.

What are the signs and symptoms of Atrophic vaginitis? Common signs and symptoms include:

• Problems with urination, such as: burning, frequency, urgency, loss of urine, and pain.
• Vulvar itching and/or burning.
• Bleeding/Spotting.
• Pain with intercourse.

How is Atrophic vaginitis diagnosed (identified)?
Your doctor or health care provider will examine the vulva and vaginal skin. A sample of vaginal discharge is obtained and examined by your doctor. This information is used to determine if you have the changes seen with atrophic vaginitis.

What is the cause of Atrophic vaginitis?
A lack or decrease in estrogen in the vulvar and vaginal areas causes atrophic vaginitis. This decrease of estrogen affects women differently. When a woman's estrogen begins to decrease, some women will develop atrophic vaginitis.

What is the treatment of Atrophic vaginitis?
Treatment may include any of the following:
• Follow Guidelines for Vulvar Skin Care.
• Estrogen Replacement Therapy helps to restore the body's estrogen levels. There are two ways to do this:
? Systemic Estrogen Replacement provides estrogen to the whole body.
? Oral Estrogen This involves taking an estrogen pill as prescribed by your health care provider. Some of the most commonly used forms include Estrace, Ogen, Orthoest, and Premarin.
? A Transdermal Patch This is a patch that is applied one or two times a week and gives the estrogen hormone through the skin. It is applied on the upper parts of the body. Some commonly used brands are Climara and Estraderm.
NOTE: If you still have your uterus and you are on systemic estrogen replacement therapy you will be prescribed a hormone called progesterone. Types of progesterone prescribed may include Provera or Cycrin.
? Dietary-based phytoestrogens In a few patients, plant-derived phytoestrogens can be used. Food sources of phytoestrogens can be found in soy milk or tofu
? Topical Estrogen Replacement provides estrogen to the area where it is applied. Topical Estrogen is the other way to restore the decreased estrogen levels in your vulvar vaginal skin. The topical cream is inserted into the vagina with a vaginal applicator or applied directly to the vulvar skin. Commonly used brands are Dienesterol, Estrace, Ogen, and Premarin.
Helpful Hints
1. Use of a lubricant with intercourse (such as vegetable oil).
2. Place a small amount of Estrogen cream on the applicator to make insertion easier.

Peer Review Status: Internally
Peer Review Date: 2004