Atrophic vaginitis is a highly under-diagnosed women’s health issue and it is generally observed in post menopausal women. It is assumed that up to 40% of the post menopausal women suffer from this condition. Menopause is the leading cause for the reduction in estrogen levels leading to this complication. Non-menopausal women may also suffer from it if their estrogen levels decrease due to various reasons.
The condition is generally caused due to the decrease in estrogen levels and it is commonly observed in women who are on anti-estrogenic medications or those who have a surgical or medical condition leading to poor estrogen levels. The diseases also called vulvar vestibulitis may also be caused by medications prescribed for treatment of endometriosis, infertility, fibroids or breast cancer.
Some of these medications are used to lower estrogen levels in the patient. Chemotherapy or radiation to the pelvic region may be another cause.
Woman going through depression, severe stress or undertaking heavy exercises may also suffer from atrophic vaginitis. Another reason could be cessation of intercourse.
Chronic cigarette female smokers are also reported to suffer from this female disease.
It has been observed that the symptoms are more severe in women who have naturally lower levels of estrogen even before they reach menopause, are regular cigarette smokers, have non-fluctuating estrogen levels or have not had vaginal child births.
The symptoms are less severe in women who indulge in intercourse after menopause, have high androgen levels and have not had vaginal surgery.
Estrogen deficiency leads to a thinner endometrium (the tissue lining the uterus) and an increased pH level in the vagina. These factors affect both the vaginal and urinary health of the woman making her prone to increased vaginal and urinary tract infections. It also leads to mechanical weakness of the local muscles.
Some of the earliest indications of atrophic vaginitis are decreasing vaginal lubrication, other urinary and vaginal symptoms that are usually worsened by various infections. The woman may experience burning during urination, stress incontinence, slight post intercourse bleeding, painful intercourse resulting in decreased sexual interest, and malodorous vaginal discharge, soreness, burning sensation or itchiness.
Not all women suffering from these symptoms consult a doctor, thus the disease remains undiagnosed. If more women reach out for medical help, it will be easier for the doctors to tackle this uro-genital disease.
To confirm or rule out the disease, the doctor will conduct a pelvic examination. A patient suffering from the Atrophic disease will indicate pale vaginal walls. The doctor will also prescribe the wet prep test. The vaginal discharge is tested to rule out other causes. The doctor may also ask for a hormonal study to be undertaken to determine the hormonal levels.
Once the doctor has ruled out any other disease causing these symptoms, they will opt for estrogen replacement to deal with the problem.
Prescription estrogen has proved to very effective for the treatment of atrophic vaginitis. It can be prescribed in the form of suppository, vaginal tablet, cream or ring for local application. These medications help deliver estrogen locally to vaginal tissues.
Very small amounts find their way to the bloodstream. In case of menopausal women, they may be prescribed estrogen oral pills or skin patches to help with the hormonal levels.
Proper treatment and regular medications can help remove the symptoms and causes of atrophic vaginitis.