Vaginal atrophy (atrophic vaginitis)

What is vaginal atrophy (atrophic vaginitis)?

This is a condition where low estrogen causes thin, dry and inflamed vaginal skin. Vaginal atrophy is common in peri-menopause or menopause women. Some doctors term this as “urogenital syndrome” due to its associated urinary symptoms, which may include burning with urination, urinary urgency, recurrent urinary tract infections (UTI) and urinary incontinence. 

What are the symptoms of vaginal atrophy?

Symptoms vary widely between women and may include one or more of the following:

• Vaginal dryness (both baseline and reduced lubrication during sex)
• Painful sex
• Burning sensation in vagina
• Vaginal itch
• Bleeding after sex 

Other than menopause, are there other risk factors?

• Surgical removal of both ovaries 
• Chemotherapy
• Radiotherapy (particularly pelvic radiation treatment for cancer)

What are the complications of vaginal atrophy?

As vaginal skin is thin and dry with a rise in vaginal pH, there is an increased risk of infection including urinary tract infections, vaginal infections and bleeding after menopause. Inability to engage in sex can also cause relationship strain and affect one’s physiological well-being and self-esteem.

What is the treatment for vaginal atrophy?

• Topical vaginal estrogen creams and tablets

This is typically applied/inserted into the vagina twice weekly and restores the vaginal skin thickness and suppleness. Due to local topical application with low absorption into the body, it is safe to use long-term.

• Regular sex

Sexual activity increases blood flow to your vagina and keeps atrophy at bay.