Vaginal dryness is present when the tissues of the vagina are no longer well-lubricated and healthy. When these symptoms are caused by a decreased amount of estrogen in a woman’s body, this problem is called atrophic vaginitis.
Vaginitis - atrophic; Vaginitis due to reduced estrogen; Atrophic vaginitis
Causes, incidence, and risk factors
Atrophic vaginitis is caused by a decrease in estrogen.
Estrogen keeps the tissues of the vagina lubricated and healthy. Normally, the lining of the vagina makes a clear, lubricating fluid. This fluid makes sexual intercourse more comfortable. It also helps decrease vaginal dryness.
If estrogen levels drop off, the vaginal tissue shrinks and becomes thinner. This causes dryness and inflammation.
Estrogen levels normally drop after menopause. The following may also cause estrogen levels to drop:
- Medicines or hormones used in the treatment of breast cancer, endometriosis, fibroids, or infertility.
- Surgery to remove the ovaries
- Radiation treatment to the pelvic area
- Severe stress, depression, or intense exercise.
Some women develop this problem right after childbirth or while breastfeeding. Estrogen levels are lower at these times.
The vagina can also become further irritated from soaps, laundry detergents, lotions, perfumes, or douches. Certain medicines, smoking, tampons, and condoms may also cause or worsen vaginal dryness.
- Burning on urination
- Light bleeding after intercourse
- Painful sexual intercourse
- Slight vaginal discharge
- Vaginal soreness, itching or burning
Signs and tests
A pelvic exam shows that the walls of the vagina are thin, pale or red.
Your vaginal discharge may be tested to rule out other causes for the condition. You may also have hormone level tests to find out if you are in menopause.
There are many treatments for vaginal dryness. Before treating your symptoms on your own, a doctor must determine the cause of the problem.
- You can buy some lubricants and vaginal moisturizing creams without prescription. They will often moisten the area for several hours up to a day.
- Using a water-soluble vaginal lubricant during intercourse may help. Products with petroleum jelly, mineral oil, or other oils may damage latex condoms or diaphragms.
- Avoid scented soaps, lotions, perfumes, or douches.
Prescription estrogen can work well to treat atrophic vaginitis. It is available as a cream, tablet, suppository, or ring. All of these are placed directly into the vagina. These medicines deliver estrogen directly to the vaginal area. Only a little estrogen is absorbed into the bloodstream.
You may take estrogen (hormone therapy)in the form of a skin patch, or in a pill that you take by mouth if you have hot flashes or other symptoms of menopause. See: Hormone replacement therapy
Women should discuss the risks and benefits of estrogen replacement therapy with their health care provider.
Proper treatment will ease symptoms most of the time.
Vaginal dryness can:
- Make you more likely to get yeast or bacterial infections of the vagina
- Cause sores or cracks in the walls of the vagina
- Cause pain with sexual intercourse, which may affect your relationship with your partner or spouse. Talking openly with your partner may help.
Calling your health care provider
Call your health care provider if you have vaginal dryness or soreness, burning, itching, or painful sexual intercourse that does not go away when you use a water-soluble lubricant.
Eckert LO, Lentz G. Infections of the lower and upper genital tracts. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 23.
Lobo RA. Menopasue and care of the mature woman. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, Pa: Mosby Elsevier; 2012:chap 14.
Last reviewed 11/10/2013 by Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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